Fig. 1

Illustration of the iodized oil-based LAG and post-LAG CT performance. Note: A patient with occurring persistent postoperative LF in the right groin after endovascular artery repair for an infrarenal abdominal aneurysm through the right femoral artery route. In the iodized oil-based LAG procedure, a total of 15 ml of lipiodol was injected with a velocity of 1 ml/min. However, due to the slow outflow of the lipiodol, 20 min after the accomplishment of the injection, the lipiodol only went up to the middle third of the thigh (black arrowhead) under the fluoroscopy and no obvious extravasation was found (a). 4 h later, the post-LAG CT was sequentially performed. The coronal (b) and sagittal (c) MIP images show definite extravasation of lipiodol (white arrowhead) at the right thigh with at least two points. The 3D-VR image (d) clearly visualized the major flowing route of the lymphatic fluid from calf to groin (white arrow) and the LF points (white arrowhead). Besides, abnormal lymphatic collateralization in calf could be observed (d). Abbreviations: LF – lymphatic fistula; LAG – lymphangiography; post-LAG CT – post-lymphangiographic computed tomography; MIP – maximum intensity projection; 3D-VR – three-dimensional volume rendering; LVs – lymphatic vessels