case_images: PMC10647881_01
case_images: Thoracic duct embolization via percutaneous puncture of the cisterna chyli. (A) Serial fluoroscopic imaging showing the contrast agent ascending to abdominal lymph nodes; (B) Fluoroscopic imaging showing the cisterna chyli (white arrow); (C) Successful catheterization into the thoracic duct; (D) Fluoroscopic imaging following coil embolization (white arrow) and glue embolization (black arrow).
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case_images: gf02
case_images: The microcatheter was flushed with 5% dextrose solution followed by an injection of N-butyl cyanoacrylate (TruFill; Codman and Shurtleff, Raynham, MA, United States) (NBCA) in a solution of ethiodized oil (Lipiodol, Guerbet, Villepinte, France) at a proportion of 1/2 (Figure 2).
case_images: PMC10647881_02
case_images: Thoracic duct embolization via percutaneous puncture of the thoracic duct. (A) Fluoroscopic imaging showing the thoracic duct cannulated at its confluence with the left subclavian vein via a direct percutaneous access; (B) Fluoroscopic imaging following coil and liquid agent embolization.
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case_images: PMC10647881_03
case_images: Thoracic duct embolization using the transvenous approach. (A) Fluoroscopic imaging showing the chylous leak, confirming the thoracic duct lesion; (B) The transvenous approach: Thoracic duct cannulation was attempted using a microcatheter (A) passed through a macrocatheter (B), after left brachial vein access; (C) Final lymphangiography demonstrating no chylous leak.
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case_images: gf04
case_images: Competition lymphography showed a significant reduction of the leak identified previously (Figure 4).