Abstract
To assess the feasibility of percutaneous catheterization of the thoracic duct (TD) in 15 pigs. After opacification of the cisterna chyli (CC) with pedal lymphography, the CC is punctured transabdominally with a 21-gauge needle and the TD is catheterized with a 3-F catheter over a guide wire. For retrograde TD catheterization, the guide wire is advanced cephalad to a neck vein, snared, retrieved through the jugular or femoral vein, and used to insert a catheter retrogradely through the lymphovenous junction. The transabdominal wire is removed. Of 15 pigs studied, successful TD catheterization was performed in 13 (antegrade [n = 4], antegrade-retrograde [n = 9]). Two failures were due to CC anomalies. No acute complications were noted. A marker was left in the CC, and TD catheterization was repeated in two pigs, 2 and 5 days later. Percutaneous transabdominal TD catheterization in the swine is feasible, safe, and repeatable. This technique has potential clinical applications in organ transplantation and management of TD laceration.
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