title: Thoracic duct embolization for the management of chylothoraces.
abstract: OBJECTIVE
  The aim is to inform the reader on the recent advancements in the minimally invasive treatment of chylothorax.
  
  
  RESULTS
  Intranodal lymphangiography has been demonstrated to be a superior alternative to traditional pedal lymphangiography for thoracic duct embolization (TDE). TDE is associated with less morbidity and better clinical success than conservative management or surgical intervention in both traumatic and nontraumatic causes of chylothorax. TDE embolization in the pediatric population was found to be feasible.
  
  
  CONCLUSIONS
  Recent advances in the lymphangiography techniques and the accumulation of experience in treating chylous effusions have significantly broadened the adoption of TDE to treat chylothorax. TDE for traumatic chylothorax has been demonstrated to be less morbid and more effective than surgical and conservative treatment. In cases of nontraumatic chylothorax, the patient has to be evaluated by MRI and lymphangiography to exclude causes of chylothorax which cannot be managed by interruption of the thoracic duct (e.g. lymphatic malformations or chylous ascites). Future advancements in noninvasive imaging of the thoracic duct and imaging guidance during TDE will continue to refine the percutaneous management of chylous effusions.
authors.affiliation: Interventional Radiology Section, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Nadolski
authors.forename: Maxim
authors.initials: M
authors.lastname: Itkin
mesh_terms: D002404:Catheterization / Q000379:methods*; D002916:Chylothorax / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D008220:Lymphography; D008297:Male; D013897:Thoracic Duct / Q000473:pathology*; D016896:Treatment Outcome