title: Lymphatic Embolization for the Treatment of Pelvic Lymphoceles: Preliminary Experience in Five Patients.
abstract: OBJECTIVE
  To retrospectively assess the outcome of lymphatic embolization in the treatment of pelvic lymphoceles.
  
  
  METHODS
  From July 2014 to December 2015, a retrospective analysis was performed in 5 consecutive female patients (mean age, 54.6 y; range, 45-65 y) who underwent lymphangiography for the management of symptomatic pelvic lymphoceles that developed after gynecologic surgery. Sclerotherapy had failed in 4 patients. Lymphangiography was performed through an inguinal lymph node to reveal disrupted lymphatic vessels draining into the lymphocele. This inflow vessel was targeted with a fine needle, and N-butyl cyanoacrylate (NBCA) was injected. Outcomes and complications were assessed by reviewing electronic medical records and computed tomography (CT).
  
  
  RESULTS
  Lymphangiography revealed disrupted lymphatic vessels draining into the lymphocele in all patients. A single inflow vessel was seen in 3 patients and was subsequently embolized. Catheters were successfully removed upon decrease of drainage. Multiple inflow vessels were seen in the remaining 2 patients. Therapeutic effect was anticipated in 1 patient after lymphangiography alone, whereas only the dominant feeding vessel was embolized in the other. The initial procedures failed in both patients, prompting repeat embolization with adjunctive sclerotherapy. Both patients showed improvement and had their catheters removed. Follow-up CT was available in 3 patients. Two patients showed complete regression of lymphoceles, and 1 showed an asymptomatic lymphocele. No procedure-related complications occurred during a mean follow-up period of 35 weeks (range, 2-73 wk).
  
  
  CONCLUSIONS
  Lymphatic intervention was technically feasible in treating lymphoceles. However, those with multiple inflow vessels were relatively difficult to treat.
authors.affiliation: Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Yoolim
authors.initials: Y
authors.lastname: Baek
authors.affiliation: Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Je Hwan
authors.initials: JH
authors.lastname: Won
authors.affiliation: Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Suk-Joon
authors.initials: SJ
authors.lastname: Chang
authors.affiliation: Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Hee-Sug
authors.initials: HS
authors.lastname: Ryu
authors.affiliation: Department of Radiology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Soon-Young
authors.initials: SY
authors.lastname: Song
authors.affiliation: Department of Radiology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Bongguk
authors.initials: B
authors.lastname: Yim
authors.affiliation: Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: jinoomail@gmail.com.
authors.forename: Jinoo
authors.initials: J
authors.lastname: Kim
mesh_terms: D000368:Aged; D004322:Drainage; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage* / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D015552:Injections, Intralesional; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging; D008210:Lymphocele / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008220:Lymphography / Q000379:methods; D008875:Middle Aged; D010388:Pelvis; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D015911:Sclerotherapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004659:Enbucrilate