329 - From Leak to Resolution: Outcomes After Intranodal Lymphangiography and Embolization for Chylous Leaks in Cancer Patients

Wednesday, April 15, 2026

11:51 AM - 12:00 PM ET

Presenting Author(s)

Mohammad Mahdi Khavandi, MD

Postdoctoral research fellow
MD Anderson Cancer Center, United States

Author/Co-author(s)

MG

Mark Gao

student
ttuhsc, United States
Mohamed E. Abdelsalam, MD

Associate Professor
UT MD Anderson Cancer Center, United States
RA

Rony Avristsher
Stephen Chen, MD

Associate Professor
MD Anderson, United States
Steven Yevich, MD, FSIR, MPH

Interventional Radiologist
MD Anderson Cancer Center, United States
RS

Rahul A. Sheth, MD, FSIR

Associate Professor
MD Anderson, United States
JK

Joshua D. Kuban, MD, FSIR, MA

Associate Professor
MD Anderson Cancer Center, United States
Peiman Habibollahi, MD, RPVI

Associate Professor
MD Anderson Cancer Center, United States

Purpose: To evaluate technical success, clinical success, and safety of intranodal lymphangiography (IL) with or without selective lymphatic embolization (LE), and to identify predictors of clinical success.

Materials and Methods: Single-center retrospective study of 46 consecutive cancer patients who underwent intranodal lymphangiography (IL) with or without selective lymphatic embolization (LE) for postoperative chylous leaks between May 2017 and July 2024. Endpoints were technical success (opacification of central conducting lymphatics during IL with completion of LE/TDE when indicated), clinical success (complete resolution or ≥50% output reduction permitting drain removal), and complications (graded by CTCAE v6). Predictors of clinical success were analyzed using Fisher’s exact and χ² tests.

Results: All procedures were technically successful (46/46, 100%). Overall, 38/46 achieved clinical success (82.6%; 95% CI, 39.0–92.7) and Lymphatic leaks were identified in all of them; all 38 underwent embolization. Requiring only one procedure strongly predicted success: 80% with a single session vs 6.3% with multiple sessions (p< 0.001; OR 12.8, 95% CI 1.9–86.1). No significant associations were observed with demographics, biochemical markers, leak location, or whether embolization was performed. One grade 2 complication occurred, which was transient dyspnea attributed to pulmonary oil embolism.

Conclusion: In cancer patients with post-surgical chylous leaks, IL with selective embolization is safe and yields modest overall clinical success. Single-session success strongly predicts outcome and may inform counseling regarding the limited benefit of repeat interventions.