Abstract
Cervical lymphatic fistulae are rare but potentially severe complications of cervical surgery. Treatment options include conservative, surgical, and—more recently—interventional approaches ( 1 Warren P.S. Hogan M.J. Shiels W.E. Percutaneous transcervical thoracic duct embolization for treatment of a cervical lymphocele following anterior spinal fusion: a case report. J Vasc Interv Radiol. 2013; 24: 1901-1905 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar ). Especially in high-output fistulae, interventional treatment options increasingly have been used with the most available data for transabdominal access to the thoracic duct (TD) with antegrade cannulation and embolization ( 1 Warren P.S. Hogan M.J. Shiels W.E. Percutaneous transcervical thoracic duct embolization for treatment of a cervical lymphocele following anterior spinal fusion: a case report. J Vasc Interv Radiol. 2013; 24: 1901-1905 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar ). However, transabdominal embolization may not always be possible (eg, when lymph vessels are < 2–3 mm in diameter). As an alternative, retrograde cannulation of the TD, using a transvenous approach ( 2 Koike Y. Hirai C. Nishimura J. Moriya N. Katsumata Y. Percutaneous transvenous embolization of the thoracic duct in the treatment of chylothorax in two patients. J Vasc Interv Radiol. 2013; 24: 135-137 Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar ) or through cannulation via a lymphocele ( 1 Warren P.S. Hogan M.J. Shiels W.E. Percutaneous transcervical thoracic duct embolization for treatment of a cervical lymphocele following anterior spinal fusion: a case report. J Vasc Interv Radiol. 2013; 24: 1901-1905 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar ), has been described. We report an alternative direct percutaneous cervical access to the TD with retrograde embolization in a patient with a high-output cervical chylous fistula.
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