title: Lymphatic Interventions for Treatment of Chylothorax.
abstract: OBJECTIVE
  To determine effectiveness of lymphatic interventional procedures for treatment of chylothorax.
  
  
  METHODS
  Analysis of interventions performed from 2001 to 2014.
  
  
  RESULTS
  In 21 patients with therapy resistant chylothorax a lymphatic radiological intervention was attempted, which could be performed in 19 cases: 17 thoracic duct embolizations (15 transabdominal, one transzervical and one retrograde transvenous procedure), 2 percutaneous destructions of lymphatic vessels, one CT-guided injection of ethanol next to a duplicated thoracic duct. Fourteen of seventeen (82.3 %) of the technically successful embolizations lead to clinical cure. This encluded three patients with prior unsuccessful surgical thoracic duct ligation. Also the injection of ethanol was clinically effective. Complications were a bile peritonitis requiring operation, and one clinical deterioration of unknown cause.
  
  
  CONCLUSIONS
  Interventional lymphatic procedures allow for effective treatment in many cases of chylothorax, and should be considered early during treatment.
  
  
  CONCLUSIONS
  • Thoracic duct embolization is an effective treatment method for chylothorax. • If embolization is impossible, percutaneous lymphatic destruction or injection of sclerosants/tissue adhesive next to the thoracic duct may be tried.
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: H H
authors.initials: HH
authors.lastname: Schild
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: C P
authors.initials: CP
authors.lastname: Naehle
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: K E
authors.initials: KE
authors.lastname: Wilhelm
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Germany.
authors.forename: C K
authors.initials: CK
authors.lastname: Kuhl
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Thomas
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Textor
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Strunk
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: W A
authors.initials: WA
authors.lastname: Willinek
authors.affiliation: Department of Radiology, University Hospital, Bonn, Germany.
authors.forename: C C
authors.initials: CC
authors.lastname: Pieper
mesh_terms: D000328:Adult; D000368:Aged; D002916:Chylothorax / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics