The number of publications regarding thoracic duct embolization is booming. It was only 2250 papers between 1975-2000, doubled (4720) between 2000-2010 and has now reached nearly 7000 papers published within the last 8 years.
The thoracic duct is the body's largest lymphatic conduit, draining upwards of 75% of lym-phatic fluid and extending from the cisterna chyli to the left jugulovenous angle. Thoracic duct embolization for chylous thoracic effusion is emerging as a result of the increasing popularity of minimally invasive neck and thoracic area surgery.
Chylous leakage and chylous ascites may result in significant morbidity and mortality. Although conservative dietary treatments and invasive open surgery methods exist, the majority of tho-racic duct injury require embolization in the interventional suite.
Thoracic duct embolization requires a combination of very basic angiography and interventional radiology skills, such as fluoroscopic guidance, ultrasound guidance, percutaneous access of cisterna chyli or lower thoracic duct followed by wiring and cannulation, embolization with coils and glue. Thoracic duct embolization is an emerging technique; however, the required skills are all well known to us. Once one understands the anatomy and pitfalls of this procedure, Thoracic duct embolization should not be a challenging procedure.
View full abstract