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J Vasc Interv Radiol. 2012 Jan;23(1):76-9. doi: 10.1016/j.jvir.2011.10.008. Epub 2011 Nov 23.

Delayed complications following technically successful thoracic duct embolization.

Author information

1
Department of Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St, Philadelphia, PA 19104, USA.

Abstract

PURPOSE:

Thoracic duct (TD) embolization (TDE) has become a universally accepted treatment of chylous pleural effusion. However, the long-term sequelae of occlusion of the TD are unknown. The objective of the present study was to determine the rate of delayed complications after technically successful TDE.

MATERIALS AND METHODS:

A total of 169 patients underwent TDE for symptomatic chylous effusion between January 1, 1994, and June 11, 2010. In 106 of 169 cases (63%), TDE embolization was technically successful. Retrospective review of these charts was performed, and patients were interviewed to determine the development of lower-extremity edema, diarrhea, abdominal swelling, and other symptoms.

RESULTS:

Follow-up information was available in 78 of 106 patients (73.6%). Mean length of follow-up was 34 months. During follow-up, 32 patients (41%) died of causes unrelated to TDE, and 46 (59%) were alive at the end of follow-up. The families of three deceased patients were available for interview. Four of 49 patients (8%) had chronic leg swelling that was probably related to the procedure, three (6%) had abdominal swelling, and six (12%) had chronic diarrhea. In four of these six cases, diarrhea was considered "probably related" to the procedure. Overall, a 14.3% rate of probably-related long-term complications after TDE was recorded.

CONCLUSIONS:

Chronic diarrhea and lower-extremity swelling may be related to TDE and should be part of informed consent before the procedure. A prospective follow-up study is needed to further establish these relationships.

PMID:
22115569
DOI:
10.1016/j.jvir.2011.10.008
[Indexed for MEDLINE]

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