Fig. 12

Illustration of percutaneous ALVE using a “cutting-off” technique. In a PLL pig model, puncture the needle targeting the afferent lymphatic vessel (white arrowhead) under fluoroscopy (A, paralleled flat detector position). Then, cut off the target lymphatic vessel (white arrowhead) (B, paralleled flat detector position) and inject 1 ml NBCA/lipiodol mixture (1:2) when simultaneously withdrawing the needle. Repeat the same operations to ensure all afferent lymphatic vessels are embolized (C). After the ALVE procedure, the volume rendering image of the CT scan demonstrated the relationship between the PLL site (white arrow) and the embolized region (*) (D). Images were from Pig No. 1. Abbreviations: ALVE, afferent lymphatic vessel embolization; PLL, postoperative lymphatic leakage; NBCA, N-butyl-2-cyanoacrylate