Boston - American Association for Thoracic Surgery

AMERICAN ASSOCIATION FOR THORACIC SURGERYof the duct is dependent on being able to achieve puncture of the cisterna chyli. In66 of these 68 patients embolization of the TD was performed; in 2 patients it wasnot attempted. Endovascular coils and/or fibrin glue was used to occlude the TD.In 18 of 35 cases where catheterization of the duct was unsuccessful, TD needleinterruption was attempted. Resolution of the chyle leak was observed in 60/66(91%) patients post embolization (3 failed, 2 were lost to follow-up, and 1 diedwithin several days post-procedure from unrelated causes). Needle interruption ofthe TD was successful in 13/18 (72%). patients. In 14 of the 17 patients who hadprevious attempts at TD ligation, embolization or interruption was attempted in14 and was successful in 11 (78%). The overall success rate for the entire series was72% (73/103). There were three minor (3%) complications: 1 asymptomatic embolizationof glue into the pulmonary artery and 2 patients developed transient lowerextremity edema.CONCLUSION: Catheter embolization or needle interruption of the thoracicduct was safe, feasible and successful in eliminating a high output chyle leak in themajority (72%) of cases. This minimally invasive, though technically challenging,procedure should be the initial approach employed for the treatment of a traumaticchylous.TUESDAYMorning153