Fig. 11

Illustration of percutaneous ALVS. In the PLL pig model, the post-lymphangiography CT scan showed a definite lipiodol extravasation (white arrow) at the left groin from the afferent lymphatic vessels (white arrowheads) at the left thigh (A). After confirming the afferent vessels responsible for the PLL, percutaneously advance a 22-gauge Chiba needle and make the needle tip close to the target lymphatic vessels (white arrowhead) at the left thigh (B). Inject 2 ml diluted iodinated contrast to show an ideal contrast dispersion completely covering the afferent vessels (*) (C). After sequential sclerotherapy by injecting 2 ml of 95% ethanol, remove the needle and carry out the CT scan presenting gas bubbles in the center of the dispersed iodinated contrast (D). Images were from Pig No. 5. Abbreviations: ALVS, afferent lymphatic vessel sclerotherapy; PLL, postoperative lymphatic leakage; CT, computed tomography