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CVIR Endovascular
Fig. 7 | CVIR Endovascular

Fig. 7

From: The roles of iodized oil-based lymphangiography and post-lymphangiographic computed tomography for specific lymphatic intervention planning in patients with postoperative lymphatic fistula: a literature review and case series

Fig. 7

A patient underwent ALVS procedure after post-LAG CT. Note: After the surgery, the right chylothorax appeared with hyperdensity of the right lower lung in the chest radiogram (a). The coronal MIP images of post-LAG CT demonstrated a definite rupture (white arrowhead) of the thoracic duct (white arrows) and the extravasation to the right pleural cavity (b). The axial MIP image demonstrated a clear rupture of the thoracic duct (c). The lower thoracic duct was regarded as the target afferent LV for the ALVS and a 21-G Chiba needle was used to puncture close to the lower thoracic duct (d). Afterwards, 1 ml contrast followed with 4.0 ml 95% Ethanol being injected. The post-ALVS CT scan showed an ideal distribution of the sclerosant around the target thoracic duct (e). Eleven (11) days after ALVS, the chest radiogram shows no obvious recurrence of the chylothorax (f). Abbreviations: ALVS – afferent lymphatic vessel sclerotherapy; post-LAG CT – post-lymphangiographic computed tomography; MIP – maximum intensity projection; LV – lymphatic vessel

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