Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.20230101
Jornal Vascular Brasileiro
Case Report

The essential role of thoracic duct embolization in management of traumatic iatrogenic chylothorax

O papel fundamental da embolização do ducto torácico no manejo de quilotórax traumático iatrogênico

Bruno Pagnin Schmid; Guilherme Moratti Gilberto; Marcela Juliano Silva Cunha; Leonardo Guedes Moreira Valle; Gustavo Foronda; Santiago Raul Arrieta; Felipe Nasser; Rodrigo Gobbo Garcia

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Abstract

This study aims to describe a case series of patients who underwent thoracic duct embolization (TDE) to treat traumatic iatrogenic chylothorax (TIC). Three patients were included: Case #1, a 49-year-old woman with follicular lymphoma developed a TIC following video-assisted thoracoscopic surgery to resect a solid right paravertebral mass and was treated with TDE using microcoils and N-butyl cyanoacrylate (NBCA) glue. Case #2, a 68-year-old man with cardiac amyloidosis developed a TIC following heart transplantation and was treated with TDE using microcoils and ethylene vinyl alcohol copolymer. Case#3: A 6-year-old patient with congenital heart disease developed a TIC following a Fontan procedure and was treated with TDE using NBCA glue. All lesions were identified during lymphangiography and TDE was successfully performed in all cases. TDE is a safe and valuable technique that provides minimally invasive treatment for TCI.

Keywords

thoracic duct, lymphangiography, chylothorax, lymphatic diseases, interventional radiology, embolization, therapeutic

Resumo

Este estudo objetiva descrever uma série de casos de pacientes submetidos a embolização do ducto torácico (EDT) para tratamento de quilotórax iatrogênico (QI). Três pacientes foram incluídos. Caso 1: um homem de 49 anos com linfoma folicular apresentou QI após ressecção de uma massa paravertebral por toracoscopia vídeo-assistida e foi submetido a EDT com micromolas e n-butil-cianoacrilato (NBCA). Caso 2: um homem de 68 anos com amiloidose cardíaca apresentou QI após ser submetido a transplante cardíaco e foi submetido a EDT com micromolas e copolímero de etileno e álcool vinílico. Caso 3: um paciente de 6 anos com malformação cardíaca congênita apresentou QI após cirurgia de Fontan e foi submetido a EDT com NBCA. Todas as lesões foram identificadas durante a linfangiografia, e a EDT foi realizada com sucesso. A EDT é uma técnica segura e valiosa, que pode oferecer um tratamento minimamente invasivo em casos de QI.
 

Palavras-chave

ducto torácico, linfografia, quilotórax, doenças linfáticas, radiologia intervencionista, embolização terapêutica

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Submitted date:
06/27/2023

Accepted date:
08/10/2023

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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