Reversed Approach through Lymphocele/Lymphatic Fluid Collection for Glue Embolization of Injured Lymphatic Vessels

Author(s):  
Joonho Hur ◽  
Saebeom Hur ◽  
Ji Hoon Shin ◽  
Se Hwan Kwon ◽  
Dongho Hyun ◽  
...  
2021 ◽  
pp. 153857442110623
Author(s):  
Chris Bent

Iodized oil-based lymphangiography (LAG) is a well-established diagnostic exam during the workup of postoperative lymphatic leaks. Computed tomography (CT) has been shown to be a useful complement to optimize treatment planning and can easily be performed after conventional LAG. The treatment options for lymphatic leaks include conservative dietary modification, sclerotherapy, embolization, and surgery. We present a case of a 48-year-old man who developed a symptomatic left retroperitoneal lymphatic fluid collection after left nephrectomy, complicated by postoperative retroperitoneal abscess. Retroperitoneal duct leak was confirmed via ultrasound-guided intranodal LAG and post-LAG CT. This leak was successfully managed with N-butyl cyanoacrylate glue embolization of the leaking lymphatics via fluoroscopic-guided catheterization of the leak via percutaneous access through the lymphatic fluid collection.


2011 ◽  
Vol 24 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Johannes L. Khol ◽  
Pablo J. Pinedo ◽  
Claus D. Buergelt ◽  
Laura M. Neumann ◽  
Walter Baumgartner ◽  
...  

The objective of the current study was to evaluate the feasibility of lymph collection from the bovine udder and to investigate if the lymphatic fluid might be of diagnostic value in cows infected with Mycobacterium avium subsp. paratuberculosis (MAP), the etiologic agent of paratuberculosis. Lymph fluid collection was attempted from 58 cows, and the reactions of the cows as well as the level of difficulty of the procedure were recorded in 56 animals. Lymph samples (51 in total) were tested for the presence of MAP by nested polymerase chain reaction. Collection of the lymphatic fluid caused no or mild signs of discomfort in 94.6% of the cows; in 51.8% of cows, lymphatic fluid was attained on the first attempt, while sample collection was unsuccessful in 12.1%. Mycobacterium avium subsp. paratuberculosis was detected in 43.1% of all lymph samples. The bacterium was present in 66.7% of cows with clinical Johne’s disease, in 42.8% of asymptomatic cows with a positive or suspicious enzyme-linked immunosorbent assay (ELISA) result in blood, and in 38.7% of cows with a negative ELISA result in blood. The present study shows that the procedure was well tolerated by most cows and can easily be performed on farm. The current report of the isolation of MAP from lymph fluid suggests that the present approach could be used for the early detection of Johne’s disease in cattle.


2004 ◽  
Vol 286 (3) ◽  
pp. H878-H883 ◽  
Author(s):  
Nanae Hangai-Hoger ◽  
Pedro Cabrales ◽  
Juan C. Briceño ◽  
Amy G. Tsai ◽  
Marcos Intaglietta

Oxygen phosphorescence quenching was used to measure tissue Po2 of lymphatic vessels of 43.6 ± 23.1 μm (mean ± SD) diameter in tissue locations of the rat mesentery classified according to anatomic location. Lymph and adipose tissue Po2 were 20.6 ± 9.1 and 34.1 ± 7.8 mmHg, respectively, with the difference being statistically significant. Rare microlymphatic vessels in connective tissue not surrounded by microvessels had a Po2 of 0.8 ± 0.2 mmHg, whereas the surrounding tissue Po2 was 3.0 ± 3.2 mmHg, with both values being significantly lower than those of adipose tissue. Lower of lymph fluid Po2 relative to the surrounding tissue was also evident in paired measurements of Po2 in the lymphatic vessels and perilymphatic adipose tissue, which was significantly lower than the Po2 in paired adipose tissue. The Po2 of the lymphatic fluid of the mesenteric microlymphatics is consistently lower than that of the surrounding adipose tissue by ∼11 mmHg; therefore, lymph fluid has the lowest Po2 of this tissue. The disparity between lymph and tissue Po2 is attributed to the microlymphatic vessel wall and lymphocyte oxygen consumption.


Author(s):  
Khairunnisa’ Md Yusof ◽  
Kira Groen ◽  
Rozita Rosli ◽  
Kelly A. Avery-Kiejda

Secondary lymphedema is characterized by lymphatic fluid retention and subsequent tissue swelling in one or both limbs that can lead to decreased quality of life. It often arises after loss, obstruction, or blockage of lymphatic vessels due to multifactorial modalities, such as lymphatic insults after surgery, immune system dysfunction, deposition of fat that compresses the lymphatic capillaries, fibrosis, and inflammation. Although secondary lymphedema is often associated with breast cancer, the condition can occur in patients with any type of cancer that requires lymphadenectomy such as gynecological, genitourinary, or head and neck cancers. MicroRNAs demonstrate pivotal roles in regulating gene expression in biological processes such as lymphangiogenesis, angiogenesis, modulation of the immune system, and oxidative stress. MicroRNA profiling has led to the discovery of the molecular mechanisms involved in the pathophysiology of auto-immune, inflammation-related, and metabolic diseases. Although the role of microRNAs in regulating secondary lymphedema is yet to be elucidated, the crosstalk between microRNAs and molecular factors involved in the pathological features of lymphedema, such as skin fibrosis, inflammation, immune dysregulation, and aberrant lipid metabolism have been demonstrated in several studies. MicroRNAs have the potential to serve as biomarkers for diseases and elucidation of their roles in lymphedema can provide a better understanding or new insights of the mechanisms underlying this debilitating condition.


2020 ◽  
Vol 63 (4) ◽  
pp. 206-213 ◽  
Author(s):  
Il-Kug Kim ◽  
Hak Chang

Lymphedema is a debilitating and progressive condition, which results in the accumulation of lymphatic fluid within the interstitial compartments of tissues and hypertrophy of adipose tissue due to the impairment of lymphatic circulation. The mainstay of current lymphedema treatment is nonsurgical management such as complex decongestive therapy and compression therapy. Recently, surgical treatment of lymphedema based on microsurgery has been developed to enable the functional recovery of lymphatic drainage and has complemented nonsurgical treatment. Lymphaticovenular anastomosis and vascularized lymph node transfer are representative physiologic surgeries in the treatment of lymphedema. Lymphaticovenular anastomosis is conducted to drain lymphatic fluid from obstructed lymphatic vessels to the venous circulation through surgically created lymphaticovenous shunts. Vascularized lymph node transfer involves harvesting lymph nodes with their vascular supply and transferring this vascularized tissue to the lymphedema lesion as a free flap. In addition to physiologic surgeries, ablative surgeries such as direct excision and liposuction also can be performed, especially for end-stage cases. Indications for surgical treatment vary across institutions. It is important not to delay physiologic surgery in mild to moderate cases of lymphedema.


2022 ◽  
Vol 13 (1) ◽  
Author(s):  
Mehmet Sait Albayram ◽  
Garrett Smith ◽  
Fatih Tufan ◽  
Ibrahim Sacit Tuna ◽  
Mehmet Bostancıklıoğlu ◽  
...  

AbstractMeningeal lymphatic vessels have been described in animal studies, but limited comparable data is available in human studies. Here we show dural lymphatic structures along the dural venous sinuses in dorsal regions and along cranial nerves in the ventral regions in the human brain. 3D T2-Fluid Attenuated Inversion Recovery magnetic resonance imaging relies on internal signals of protein rich lymphatic fluid rather than contrast media and is used in the present study to visualize the major human dural lymphatic structures. Moreover we detect direct connections between lymphatic fluid channels along the cranial nerves and vascular structures and the cervical lymph nodes. We also identify age-related cervical lymph node atrophy and thickening of lymphatics channels in both dorsal and ventral regions, findings which reflect the reduced lymphatic output of the aged brain.


1990 ◽  
Vol 26 (4) ◽  
pp. 697
Author(s):  
M Y Kim ◽  
C H Suh ◽  
S H Lee ◽  
H R Choi ◽  
B Y Ahn ◽  
...  
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