Abstract
In 1998, a novel procedure, embolization of the thoracic duct via direct puncture of the cisterna chyli, was conceived by Constantin Cope ( 1 Cope C. Diagnosis and treatment of postoperative chyle leakage via percutaneous transabdominal catheterization of the cisterna chyli: a preliminary study. J Vasc Interv Radiol. 1998; 9: 727-734 Abstract Full Text PDF PubMed Scopus (138) Google Scholar ). As part of this procedure, the cisterna chyli is catheterized by means of fluoroscopically guiding a 21-gauge needle all the way through the abdomen (and its visceral contents) into this small saclike lymphatic structure. This structure resides in the retrocrural space adjacent to the aorta and is usually not even visible on computed tomography. The fact that this procedure can be done at all is a tribute to Dr. Cope and the field of interventional radiology. Thoracic duct embolization has been reported by Itkin et al ( 2 Itkin M. Kucharczuk J.C. Kwak A. Trerotola S.O. Kaiser L.R. Nonoperative thoracic duct embolization for traumatic thoracic duct leak: experience in 109 patients. J Thorac Cardiovasc Surg. 2010; 139: 584-589 Abstract Full Text Full Text PDF PubMed Scopus (227) Google Scholar ) to clinically control chylothorax in as many as 90% of patients. Unfortunately, to catheterize the cisterna chyli, it must first be opacified by means of pedal lymphangiography. Feasibility of Ultrasound-guided Intranodal Lymphangiogram for Thoracic Duct EmbolizationJournal of Vascular and Interventional RadiologyVol. 23Issue 5PreviewTo show the feasibility of opacifying the thoracic duct using ultrasound-guided intranodal lymphangiogram (IL) for thoracic duct embolization (TDE). Full-Text PDF
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