title: Therapeutic lymphangiography and CT-guided sclerotherapy for the treatment of refractory lymphatic leakage.
abstract: OBJECTIVE
  To evaluate therapeutic lymphangiography and computed tomography (CT)-guided sclerotherapy for the treatment of refractory inguinal, pelvic, abdominal, and thoracic lymphatic leakage.
  
  
  METHODS
  Between January 2008 and April 2011, 18 patients with refractory lymphatic leakage were treated with therapeutic lymphangiography. Additionally, 10 of these 18 patients underwent CT-guided sclerotherapy with injection of ethanol at the site of the leakage. In the delayed sclerotherapy group (n = 5), the sclerotherapy procedure was performed when the leak persisted after therapeutic lymphangiography. In the immediate sclerotherapy group (n = 5), sclerotherapy was performed on the same day as lymphangiography. The sites of the lymphatic leakage were as follows: inguinal leakage in 8 patients, pelvic leakage in 4 patients, abdominal leakage in 2 patients, and thoracic leakage in 4 patients. Data collected included technical success, clinical success, and procedural complications.
  
  
  RESULTS
  Lymphangiography was technically successful in all patients. In eight patients undergoing therapeutic lymphangiography alone, the clinical success rate was 75%, and the drainage catheter could be removed in six patients after the treatment. Lymphangiography followed by immediate sclerotherapy was clinically successful in four of five patients. Lymphangiography combined with delayed sclerotherapy was clinically successful in three of five patients. Overall, the clinical success rate was 72% (13 of 18 patients). One minor complication occurred.
  
  
  CONCLUSIONS
  Therapeutic lymphangiography alone or in combination with CT-guided sclerotherapy is a promising treatment option for the management of refractory lymphatic leakage.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120. Electronic address: nikolas.kortes@med.uni-heidelberg.de.
authors.forename: Nikolas
authors.initials: N
authors.lastname: Kortes
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120.
authors.forename: Boris
authors.initials: B
authors.lastname: Radeleff
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120.
authors.forename: Christof-Matthias
authors.initials: CM
authors.lastname: Sommer
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120.
authors.forename: Nadine
authors.initials: N
authors.lastname: Bellemann
authors.affiliation: Department of Surgery, University Hospital Heidelberg, INF 110, Heidelberg 69120.
authors.forename: Katja
authors.initials: K
authors.lastname: Ott
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120; Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany.
authors.forename: Götz Martin
authors.initials: GM
authors.lastname: Richter
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, Heidelberg 69120.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Stampfl
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003287:Contrast Media / Q000008:administration & dosage; D004322:Drainage; D000431:Ethanol / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D008220:Lymphography; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D012597:Sclerosing Solutions; D000431:Ethanol; D004998:Ethiodized Oil