SIR 2024
General IR
Julia Gallagher, BA (she/her/hers)
Medical Student
University of South Florida Morsani College of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Aditya Garg, BA
Medical Student
University of South Florida Morsani College of Medicine
Disclosure information not submitted.
Andrew Muran, BA
Medical Student
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Disclosure information not submitted.
Eusha R. Hasan, BA
Medical Student
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Financial relationships: Full list of relationships is listed on the CME information page.
Elias Salloum, MD
Assistant Member in the Department of Diagnostic Imaging and Interventional Radiology
Moffitt Cancer Center
Disclosure information not submitted.
Mustafa Al-Roubaie, MD
Associate Professor
Moffitt Cancer Center, University of South Florida Morsani College of Medicine
Disclosure information not submitted.
1. Discuss the clinical applications of performing thoracic duct stenting.
2. Review the procedural details of thoracic duct stenting.
3. Examine the challenges and complications associated with thoracic duct stenting.
Background:
Disruption of the lymphatic system can arise from trauma, iatrogenic injury, liver cirrhosis, infection, or idiopathic etiologies. The sequelae of lymphatic disruption, including chyluria, chylous thorax, ascites, and lymphedema, can lead to significant patient morbidity or mortality. Thoracic duct (TD) stenting is a less frequently reported technique that is used in interventional radiology for treatment of lymphatic obstruction with associated lymphatic disruption. A small number of cases have reported the utility of TD stenting in managing patient morbidity associated with disruption of the lymphatic system in the setting of TD obstruction.
Clinical Findings/Procedure Details:
This educational exhibit will describe cases that demonstrate the clinical applications of TD stenting. Through a case-based discussion, the educational exhibit will review procedural details, indications, and complications associated with this technique. We will detail 2 cases in which TD stentings were used to manage recurrent ascites by reducing TD pressures in patients unable to receive TIPS {1}. We will describe a case of TD stenting that treated a chyle leak following a left nephrectomy for renal cancer {2}. Finally, we will present 2 cases that used TD stenting to treat chyluria secondary to elevated TD pressures from obstruction at the TD and subclavian vein junction {3,4}.
Conclusion and/or Teaching Points:
TD stenting has successfully and safely been used to relieve lymphatic obstruction. This technique can treat a wide variety of patient morbidities associated with lymphatic system disruption in the setting of TD obstruction. Interventionalists evaluating and treating patients with lymphatic injury should be familiar with the techniques and role of TD stenting to manage associated lymphatic obstruction.