Glue Embolization Research Articles

Percutaneous computed tomography-guided glue embolization of a pancreatic pseudoaneurysm with underlying occluded celiac and superior mesenteric artery.

Percutaneous computed tomography-guided glue embolization of a pancreatic pseudoaneurysm with underlying occluded celiac and superior mesenteric artery.

Blocked-flow vs. free-flow cyanoacrylate glue embolization: Histological differences in an in vivo rabbit renal artery model

PurposeThe purpose of this in vivo animal study was to compare the acute histological effects on the arterial vessel wall of free-flow vs. blocked-flow embolization with metacryloxysulfolane-n‑butyl cyanoacrylate (MS-NBCA) in several concentrations. Materials and methodsA total of 42 rabbit renal arteries were embolized using MS-NBCA mixed with ethiodized oil. The MS-NBCA concentration was 12.5%, 25%, or 50%. All mixtures were injected under both free-flow and blocked-flow conditions. The rabbits were euthanised 30 min after arterial embolization. Arterial-lumen distension, intimal inflammation and necrosis, peri‑arterial edema, and distality of MS-NBCA penetration were assessed histologically. Multivariable regression analyses were performed using a manual backward procedure, with linear, ordinal and logistic regression to search for factors associated with these outcomes ResultsMarked or severe dilatation was observed in 36 out of 42 arteries (86%) and marked or transmural intimal arteritis in all 42 arteries (42/42; 100%). Lumen dilatation caused focal vessel-wall flattening, which resulted in intimal necrosis. Multifocal necrosis extending from the intima to the media occurred in 23 out of 42 kidneys (55%) and peri‑arterial edema with multifocal vascular leakage in 19 out of 42 kidneys (45%). At multivariable analysis, blocked-flow MS-NBCA injection was associated with greater severity of vessel-wall lesions, including intimal arteritis (P = 0.003) and intimal necrosis (P = 0.014), compared to free-flow injection. Blocked-flow injection was also associated with peri‑arterial edema (P = 0.008) and greater distality of MS-NBCA penetration (P = 0.001). ConclusionBlocked-flow MS-NBCA injection during renal artery embolization is significantly associated with more acute arterial-wall damage and greater distality of glue penetration compared to free-flow injection in a rabbit model. These preliminary findings may have clinical implications, as blocked-flow injection is routinely used to treat specific vascular diseases or malformations in human.

Surgical Management of Central Lymphatic Conduction Disorders: A Review

AimRecent advances in lymphatic imaging allow understanding the pathophysiology of lymphatic central conduction disorders with great accuracy. This new imaging data is leading to a wide range of novel surgical interventions. We present here the state-of-the-art imaging technology and current spectrum of surgical procedures available for patients with these conditions. MethodDescriptive report of the newest lymphatic imaging technology and surgical procedures and retrospective review of outcome data. ResultsThere are currently two high-resolution imaging modalities for the central lymphatic system: multi-access dynamic contrast-enhanced MR lymphangiogram (DCMRL) and central lymphangiography (CL). DCMRL is done by accessing percutaneously inguinal and mesenteric lymph nodes and periportal lymphatics vessels. DCMRL provides accurate anatomical and dynamic data on the progression, or lack thereof, of the lymphatic fluid throughout the central lymphatic system. CL is done by placing a catheter percutaneously in the thoracic duct (TD). Pleural effusions are managed by pleurectomy and intraoperative lymphatic glue embolization guided by CL. Anomalies of the TD are managed by TD-to-vein anastomosis and/or ligation of aberrant TD branches. Chylous ascites and organ-specific chylous leaks are managed by intraoperative glue embolization, surgical lymphocutaneous fistulas, and ligation of aberrant peripheral lymphatic channels, among several other procedures. ConclusionThe surgical management of lymphatic conduction disorders is a new growing field within pediatric general surgery. Pediatric surgeons should be familiar with the newest imaging modalities of the lymphatic system and with the surgical options available for patients with these complex surgical conditions to provide prompt treatment or referral. Level of EvidenceV.

Endovascular glue embolization of the medial posterior choroidal artery aneurysm: A case report and a literature review

Background: The medial posterior choroidal artery (MPCA) aneurysm is extremely uncommon. Thus yet, just a few cases have been reported. Due to the deep position, narrow lumen, fragile walls, and extensive tortuosity, both endovascular and microsurgical procedures are strictly limited. A case study of successful endovascular glue embolization of a left MPCA aneurysm and a literature review is included in this report. Case Description: A 17-year-old female arrived at our institution 2 days after suffering a major intraventricular hemorrhage with a minor subarachnoid hemorrhage. Digital subtraction angiography revealed a left MPCA aneurysm. The patient underwent a successful endovascular glue embolization and had a favorable functional outcome. Conclusion: Endovascular glue embolization yielded favorable clinical and angiographic results in MPCA aneurysms where microcatheter access and maneuverability are challenging.

Advances in Endohepatology.

Over the past decade, the number of endoscopic procedures relevant to patients with liver disease not only increased but also altered and expanded in terms of indications and applications. "Endohepatology" refers to the integration of advanced endoscopy within the practice of hepatology with endoscopic ultrasound as one of the main pillars. Current applications under the umbrella of endohepatology focus on advanced diagnostics and oncological, vascular, and metabolic interventions. These involve, among others, endoscopic ultrasound (EUS)-guided liver biopsy, EUS-guided portal pressure gradient measurement, and EUS-guided coil and glue embolization of gastric varices. In addition to its conceptually attractive technical and innovative characteristics, endohepatology is also an appealing practical option for daily practice because it can be offered as a "one-stop clinic" intervention where comprehensive endoscopic diagnostic and/or therapeutic testing is performed in a single outpatient visit. In this review, we will discuss current trends and future developments within endohepatology and the remaining hurdles to overcome.

Selective transarterial embolization for arterial hemorrhage after upper third molar extraction: illustrative cases.

The present report describes 2 cases of arterial bleeding after removal of the upper third molar that were successfully treated with selective transarterial embolization. The first patient underwent removal of the left upper third molar. A few hours later, facial swelling and massive bleeding appeared near the extraction socket involving the posterolateral wall of the maxillary sinus. Angiography showed a pseudoaneurysm involving the posterior superior dental artery, and the lesion was selectively embolized with an N-butyl cyanoacrylate (NBCA)-lipidiol mixture. The second patient underwent removal of the left upper third molar, and massive bleeding occurred from the extraction socket involving the greater palatine foramen. Angiography revealed the pseudoaneurysm of the greater palatine artery, and the lesion was selectively embolized with an NBCA-lipiodol mixture. Both patients were discharged uneventfully, and no recurrent bleeding was observed during the 82- and 5-month follow-up periods. Massive arterial bleeding after a third molar extraction occurs from either the posterior superior dental artery or the greater palatine artery, which is associated with the location of the extraction socket. Selective transarterial glue embolization is a useful option for the treatment of arterial bleeding after the removal of the upper third molars.

Lymphangiography and lymphatic embolisation for the treatment of chyle leaks after neck surgery: assessment of lymphangiography findings and embolisation techniques.

To assess lymphangiography findings and outcome of lymphatic embolisation to manage chyle leak after neck surgery. Consecutive cases of lymphangiography performed between April 2018 and May 2022 for management of chyle leaks related to neck surgery were retrospectively reviewed. Lymphangiography findings, techniques, and outcomes were analysed. Eight patients (mean age: 46.5 years) were included. Six patients had undergone radical neck dissection for thyroid cancer, and two had undergone lymph node excision. Clinical presentations were: chyle drainage through Jackson Pratt catheters in five patients, lymphorrhea through surgical wounds in two, and enlarging lymphocele in one. Lymphangiography techniques included: inguinal lymphangiography in four patients, retrograde lymphangiography in three, and transcervical lymphangiography in one. Lymphangiography revealed leaks in the terminal thoracic duct in two patients, bronchomediastinal trunk in two, jugular trunk in three, and superficial neck channels in one. Embolisation techniques included: non-selective embolisation of terminal thoracic duct (n = 2), selective embolisation of the jugular trunk (n = 3), selective embolisation of the bronchomediastinal trunk (n = 2), and intranodal glue embolisation of superficial neck channels (n = 1). One patient underwent a repeat procedure. Chyle leak resolved in all patients over a mean of 4.6 days. No complication was encountered. Lymphatic embolisation seems to be effective and safe in managing chyle leaks after neck surgery. Lymphangiography allowed for the categorisation of chyle leaks according to their location. Post-embolisation patency of the thoracic duct may be preserved in chyle leaks that do not directly involve the thoracic duct. Lymphatic embolisation is safe and effective in managing chyle leaks after neck surgery. On lymphangiography, the location of contrast media extravasation may not be consistent. The technique for embolisation should be based on the location of the leak. Post-embolisation patency of the thoracic duct may be preserved in chyle leaks that do not directly involve the thoracic duct.

A pictorial essay of ultrasound findings after endovascular procedures for superficial chronic venous disease

To date endovascular surgical techniques represent an effective and widely used choice in the treatment of superficial venous insufficiency. In recent years, tumescent ablative techniques (endovenous laser ablation, radiofrequency ablation) have been joined by non-tumescent ablative techniques (mechanical-chemical ablation and cyanoacrylate glue embolization). The Duplex ultrasound (DUS) is the survey mostly used to evaluate the outcome of these procedures. The aim of this work was to provide an updated overview of the ultrasound aspects that can be found in the follow-up of patients undergoing endovascular procedures. Specifically, the characteristic imaging pictures will be described in the immediate and short/medium term follow-up. The DUS is a fundamental element of the investigation of venous system of the lower limbs after the surgical and endovascular treatment of varicose veins. Therefore, it is necessary to update one’s knowledge regarding ultrasound patterns related to new endovascular procedures.

Pseudoaneurysm of the profunda femoris artery following hip surgery

Pseudoaneurysm of the profunda femoris artery has been described as an iatrogenic phenomenon following orthopedic surgery. It may result due to trauma or direct arterial wall injury during dynamic hip screw fixation for proximal femur fracture. We present a case of a 65-year-old female who developed sudden pain and left thigh swelling one month after surgery for left sided intertrochanteric femur fracture. Computed tomography angiography of the left lower limb revealed the presence of a pseudoaneurysm in the upper left thigh. It was successfully treated with endovascular glue embolization followed by surgical excision of the pseudoaneurysm.

Glue Embolization of an Iatrogenic Portal Vein Pseudoaneurysm Associated with Abscess Catheter Erosion

Glue Embolization of an Iatrogenic Portal Vein Pseudoaneurysm Associated with Abscess Catheter Erosion

Combined DSA- and US-guided management of acute bleeding: effectiveness of percutaneous glue embolization in six cases.

This study aims to report on safety and effectiveness of glue embolization of acute hemorrhages performed by US-guided percutaneous direct puncture, in patients where the standard endovascular approach is technically unfavourable. In this single center retrospective analysis, patients affected by traumatic or non traumatic acute hemorrhages were treated with glue embolization technically performed by US-guided direct puncture. Patients suffered from active bleeding detected at contrast-enhanced Computer Tomography and confirmed at Digital Subtracted Arteriography, with concomitant hemoglobin drop and blood pressure reduction. Six patients were reviewed; hemorrhages occurred in liver parenchima (1), gallbladder (1) and lower limbs (4). Bleedings etiologies were post-traumatic (5) and inflammatory (1); four had extraluminal blushes while 2 were pseudoaneurysms. In five cases (4 limbs and 1 hepatic bleedings) the direct-puncture approach was adopted because of technically unfavourable vascular anatomy for superselective embolization; in one case (cystic artery pseudoaneurysm), an endovascular embolization would entail a high risk of gallbladder ischemia because of its terminal arterial supply. Technical success was defined disappearance of bleeding signs at last arteriography; clinical success was considered stabilization and/or improvement of hemoglobin values and arterial pressure without additional interventions. Both technical and clinical successes were obtained in 100% of the cases without major complications. No needle occlusion occurred during glue injection. In this study percutaneous US-guided embolization by direct puncture was a safe and effective approach to manage acute bleedings; it could be considered as an alternative in patients with unfavourable vascular anatomy for the standard catheter-directed endovascular embolization.

FLOW-diverted Glue Embolization to Target lesions (FLOW-GET) technique for spinal vascular diseases: A technical note

We present and exemplify the flow-diverted glue embolization to target lesions (FLOW-GET) technique for spinal vascular diseases. In this technique, the occlusion of the posterior intercostal artery or dorsal muscular branch by coils diverts the injected glue from the segmental artery to the target lesions. This technique was applied to a ruptured retrocorporeal artery aneurysm and spinal dural arteriovenous fistulas. The FLOW-GET accomplished the complete obliteration of all lesions. This simple and useful technique can be applied to spinal vascular lesions even if a microcatheter is not placed in proper feeders or advanced close to the shunt points or aneurysms.

Abstract Number ‐ 110: Case Report of Glue Embolism Complication after Lingual Artery Embolization and Rescue Thrombectomy

Introduction 68‐year‐old right‐handed female with right tongue‐base squamous cell carcinoma status‐post wide surgical‐excision and flap reconstruction, whopresented with large volume right‐sided orolingual hemorrhage. Due to concerns of impending airway compromise and a history of difficult intubation, Interventional Neuroradiology was consulted to perform an angiogram and embolization. Methods A 6FrEnvoy was advanced into the external carotid artery and the origin of the lingual artery. Despite repeated attempts using a variety of microsystems, distal access within the lingual artery could not be achieved (Fig. 1B). N‐butyl‐2‐cyanoacrylate was prepared and injected with adequate penetration. Negative pressure was applied to the microcatheter and withdrawn. The guide catheter was aspirated and rapidly withdrawn under negative pressure. A control angiogram was being prepared when an intracranial glue cast was seen and confirmed to be a proximal M2‐occlusion. 4000U of Heparin werebolusedat this time. An Advantage Exchange wire facilitated an exchange for an 8Fr groin sheath and a Walrus catheter. The glue was crossed with a microsystem microsystem and a Solitaire‐4×40mm was deployed. A ZOOM55 was advanced to the face of the glue caste and together these were pulled into the Walrus catheter. Serial angiograms revealed stenosis, but patency. Results Initial post‐thrombectomy exam revealed mild left‐hand paresis. However, the patient’s neurologic status declined and progressed to left arm hemiparesis, facial droop, and right gaze‐preference. An angiogram was performed, which revealed re‐occlusion of the left M2 trunk. Using aTrevo‐3×32mmstentriever, the M2‐occlusion was recanalized with persistent stenosis. Serial angiograms were concerning for progressing re‐occlusion. The patient improved with residual distal left hemiparesis. Conclusions •Distal access may be extremely difficult in select cases. The proximal location of the microcatheter relative to the origin of the lingual artery and the external carotid artery off the common carotid artery, likely contributed to the embolic event. The use of progressively smaller microcatheters to facilitate distal access in turn biased the choice of embolization materials. Lastly, there was evidence of vasospasm in the lingual artery, which may have contributed to proximal polymerization and adherence to the catheters during their removal. •After successful retrieval of the glue material, there was residual stenosis of unclear etiology, possibly due to denuded endothelium, dissection, or residual glue promoting in‐situ thrombosis. The eventual clearing of thebolusedheparin may have contributed to the delayed re‐occlusion. Recanalization after re‐occlusion was only possible after thrombectomy. •The use of an intermediate catheter may mitigate the risk of glue embolization by facilitating distal access and/or by providing an additional conduit for aspirating refluxed glue. If distal access into a culprit vessel can not be achieved, coil embolization may be a safer choice. Re‐canalized glue embolisms may be prone to re‐occlusion. Continuing a heparin drip may be prudent practice to prevent re‐occlusion.

Direct Puncture of the Left Gastric Vein for Glue Embolization of Gastric Varices Associated with Sinistral Portal Hypertension

Direct Puncture of the Left Gastric Vein for Glue Embolization of Gastric Varices Associated with Sinistral Portal Hypertension

Evaluatıng the Impact of Great Saphenous Veın Reflux Pattern on Clınıcal Severıty and Treatment Modalıty

Objectives: This research aimed to determine the impact of reflux patterns in patients with great saphenous vein (GSV) insufficiency on clinical severity and management. Methods: We evaluated 771 lower extremities of 452 patients having GSV insufficiency with Doppler Ultrasound. We characterized the reflux patterns like previously done in the literature: type 1, GSV reflux without the involvement of perimalleolar region or saphenofemoral junction (SFJ); type 2, GSV reflux involving perimalleolar region; type 3, GSV reflux involving SFJ; type 4, GSV reflux involving both perimalleolar region and SFJ. Then we conducted a study to evaluate the relationship between GSV reflux type and age, gender, venous clinical severity score (VCSS), clinical, etiological, anatomical and pathophysiological elements (CEAP), body mass index (BMI) and gave an effort to compare the groups by therapeutic strategies. Results: The mean age was 44±11 years. The male-to-female ratio was 0.49. The most commonly observed reflux pattern was type 3 (48%) in patients with GSV insufficiency and varicose veins. Patients with type 1 reflux were younger, had lower BMI, and had a better clinical situation (p=0.002). VCSS was associated with perimalleolar region involvement, as increased in type 2 reflux than type 1, and higher VCSS was related to SFJ involvement as defined in type 3 reflux. Type 4 reflux patients had the highest VCSS that means the most severe clinical presentation. Sclerotherapy was the most common treatment modality in type 1 reflux (p<0.001). Also, in type 2 and type 4 reflux, sclerotherapy was more preferred than type 3 (p<0.001). Type 4 reflux pattern required mostly radiofrequency ablation, compared with type 3 (28.2% vs 20.5%; p<0.05) after initial diagnosis. Cyanoacrylate glue embolization was the appropriate therapeutic option in only 3.2% of type 4 reflux patients, which was significantly lower than type 3. Conclusion: According to the reflux pattern classification system based on SFJ and malleolar region involvement as practiced in this study, we described a correlation between VCSS, CEAP, BMI, and the extent of venous insufficiency. This correlation with consideration of cosmetic reasons and vein diameter measurements can suggest further treatment modality. Advances in knowledge: We investigated a practical, clinically applicable, and widely accepted standard method for classifying GSV insufficiency. Mapping venous insufficiency with such a system is essential to determine the clinical severity and the most appropriate treatment modality.

Treatment of orbital vascular malformations with intralesional bleomycin injection and N-butyl-2-cyanoacrylate glue embolization

Objective: To evaluate the clinical efficacy of bleomycin lavage combined with N-butyl-2-cyanoacrylate glue embolization and resection in the treatment of orbital vascular malformations. Methods: It was a retrospective case series study. Patients with orbital vascular malformations diagnosed at the Ophthalmology Division of Chinese PLA General Hospital from January 2018 to October 2021 were included and divided into exophthalmos group and non-exophthalmos group based on whether the patients had postural exophthalmos. Intralesional bleomycin injection and N-butyl-2-cyanoacrylate glue embolization were performed. The preoperative and postoperative visual acuity, the dosages of bleomycin and isobutyl cyanoacrylate glue, pathological results, imaging findings and remission rate were recorded and analyzed. The Chi-square test, Wilcoxon signed rank analysis and Mann-Whitney U test were used for statistical analysis. Results: A total of 58 patients (58 eyes)were included, and there were 22 males (37.9%) and 36 females (62.1%). Nineteen (32.8%) patients had postural exophthalmos, and 39 (67.2%) patients did not suffer postural exophthalmos. The patient's age of the two groups was 39.0 (28.0, 54.5) years vs. 14.0 (5.7, 26.5) years, with a statistically significant difference (Z=-3.96, P<0.001). There was no significant difference in gender, eye laterality, follow-up time and the disease course between the two groups (all P>0.05). During the operation, the dosage of bleomycin was 15 000 (13 500, 15 000) U in the exophthalmos group, and 15 000 (9 000, 16 500) U in the non-exophthalmos group (Z=-0.70, P=0.944). The dosages of N-butyl-2-cyanoacrylate glue were 2.8 (1.0, 3.0) ml and 1.7 (1.0, 2.2) ml, respectively, in the two groups, with no significant difference (Z=-1.11, P=0.268). There was no visual impairment in both groups, while the visual acuity in 5 patients without postural exophthalmos was improved postoperatively. The imaging examination results showed no difference in the malformed vascular area before and after the treatment in the exophthalmos group [384.0 (329.0, 458.0) mm2 vs. 330.5 (271.6, 356.7) mm2; Z=-1.26, P=0.208], but a significantly decreased area after the treatment in the non-exophthalmos group [960.8 (822.1, 1058.3) mm2 vs. 311.6 (164.6, 361.6) mm2; Z=-2.67, P=0.008]. All patients had no obvious local or systemic adverse reactions during the follow-up. The pathology reports showed vascular malformations in all 15 specimens obtained from the exophthalmos group, as well as vascular malformations in 41.0% (16/39) of specimens and venous lymphatic malformations in 59.0% (23/39) of specimens from the non-exophthalmos group. Thirty-nine patients had complete remission (67.2%), 19 patients had partial remission (32.8%), and the effective treatment rate was 100%. Conclusion: Bleomycin lavage combined with N-butyl-2-cyanoacrylate glue embolization can achieve good therapeutic effects on orbital vascular malformations.

Ruptured isolated spinal artery aneurysms: Case series of five patients and a review of the literature on management strategies.

Aneurysms of the spinal arteries are rare entities, the majority of which are associated with other vascular lesions, such as spinal vascular malformations. Isolated spinal artery aneurysms (SAAs) are even less frequently encountered, and their incidence is largely unknown, as the literature is limited to case reports and small series. The optimal management strategy for SAAs is not well defined. To review the institutional experience of five patients with isolated SAAs. Five cases of isolated SAAs were identified at our institution, including two cases with multiple simultaneous SAAs. Clinical presentation, imaging, and management strategies for each case were reviewed. A literature review of all SAAs reported between 1950 and 2020 was performed. A total of five patients with eight isolated SAAs presented to our institution: one aneurysm was lumbar in location, while the remaining seven were thoracic. Two patients were treated with glue embolization followed by laminectomy for hematoma evacuation; one was treated with only surgery; and the other two, which both had multiple lesions, were managed conservatively with interval complete regression of their aneurysms. All five patients had good neurological outcomes. Literature review found 124 patients with at least 137 isolated SAAs and revealed treatment strategies including conservative management, glue or coil embolization, muslin wrapping, and surgical resection or clipping. Multiple management strategies exist for SAAs, and clinical consideration of patient presentation and lesion morphology determine appropriate strategy. Our case series demonstrates three of these treatment paradigms.

An unusual complication after a variceal glue injection

A 64-year-old man with a history of atrial fibrillation with portal vein and superior mesenteric vein thrombosis was admitted to hospital with haematemesis. He was diagnosed with non-cirrhotic portal hypertension leading to variceal bleeding. He had two endoscopies with variceal banding and gastric variceal glue injection within 1 month that were unsuccessful; hence, he was referred to a tertiary unit for further management. Given his performance status and comorbidities, he was neither a candidate for surgery nor transjugular intrahepatic portosystemic shunt; therefore, after careful counselling, glue embolisation of the culprit vein was performed via an endovascular approach.

EUS-guided coil placement and cyanoacrylate glue injection for gastric variceal bleeding with obvious spontaneous portosystemic shunts.

Ectopic embolism caused by cyanoacrylate glue for the treatment of gastric varices with obvious spontaneous portosystemic shunts is a serious complication of endoscopic therapy. This study was performed to investigate the safety and therapeutic effect of EUS-guided coil placement and cyanoacrylate glue injection for gastric varices with obvious spontaneous portosystemic shunts. Six patients with gastric variceal bleeding and obvious spontaneous portosystemic shunts were included in this study. We evaluated the success rate of variceal occlusion after intraoperative embolization, the postoperative rebleeding rate at 48 h and 2 weeks posttreatment, and the incidence of ectopic embolism and other adverse events. Gastroscopy and computed tomography portal venography (CTPV) were performed 7 months later. All patients underwent successful coil placement and cyanoacrylate glue injection under EUS guidance. The blood flow was confirmed by Doppler examination, the target vessels were successfully blocked, and no rebleeding had occurred at 48 h or 2 weeks after endoscopic treatment. Gastroscopy was repeated 7 months after endoscopic treatment, revealing local ulcer formation. CTPV was also repeated 7 months after endoscopic treatment, showing that the coils were present in the target vessels with no displacement, the portosystemic shunt vessels were occluded, and no ectopic embolization had occurred. The coil placement combined with cyanoacrylate glue embolism is a safe and effective method for patients with gastric variceal bleeding and obvious spontaneous portosystemic shunts.

Intranodal Glue Embolization for Postoperative Lymphatic Leaks in the Groin and Pelvis: Comparison with Sclerotherapy

PurposeTo compare the effectiveness of and adverse events related to intranodal glue embolization (IGE) with those of intracavitary sclerotherapy for the treatment of postoperative groin and pelvic lymphatic leaks. Materials and MethodsFrom November 2015 to July 2021, IGE for postoperative pelvic or groin lymphocele or lymphorrhea was performed in 33 patients. From January 2010 to July 2021, 28 patients with postoperative pelvic or groin lymphocele were treated with sclerosis alone. Clinical success was defined as resolution of drainage within 3 weeks of the last intervention performed without recurrence. Patients presenting >1 year after surgery or with <30 days of follow-up were excluded. Patients with lymphorrhea treated with IGE were not statistically compared with those in the sclerosis group because they were not eligible for sclerosis. ResultsClinical success was similar between the groups (lymphocele IGE, 15/18, 83.3%, vs sclerosis, 15/23, 65.2% [P = .29]; lymphorrhea IGE, 8/9, 88.9%). The mean number of interventions performed to successfully treat a lymphocele was significantly higher in the sclerosis group (2.5 for sclerosis vs 1.3 for IGE; P = .003; lymphorrhea IGE, 1.0). The mean time to resolution was significantly longer for sclerosis than for IGE (27 vs 7 days; P = .002; 4 days for lymphorrhea IGE). There were no sclerosis-related adverse events and 2 IGE-related adverse events: (a) 1 case of mild lymphedema and (b) 1 case of nontarget embolization resulting in deep vein thrombosis. ConclusionsFor treatment of postoperative pelvic and groin lymphoceles, IGE results in faster resolution with fewer interventions compared with sclerosis. IGE is also an effective treatment for postoperative groin lymphorrhea.