Yamamoto Masayoshi, Yamada Kentaro, Horikawa Masahiro, Kondo Hiroshi, Oba Hiroshi, Furui Shigeru
Department of Radiology, Teikyo University Hospital, 2-11-1 Kaga, Itabashi-Ku, Tokyo, Japan.
Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Japan.
Cardiovasc Intervent Radiol. 2018 Jun;41(6):959-963. doi: 10.1007/s00270-018-1885-4. Epub 2018 Feb 7.
To report embolization of the thoracic duct by direct injection of N-butyl-2-cyanoacrylate (NBCA) glue via a puncture needle.
Two cases of high output chylothorax were successfully treated with direct injection of N-butyl-2-cyanoacrylate (NBCA) glue via a puncture needle. In them, conventional thoracic duct embolization (TDE) was attempted, but the cisterna chyli was absent on intranodal lymphangiography, and probably for this reason catheterization of the thoracic duct was unsuccessful. Contrast material injection via a puncture needle, however, clearly showed a leak from the thoracic duct, prompting us to attempt embolization of the thoracic duct by direct injection of NBCA glue via the needle.
Thoracic duct embolization by direct injection of NBCA glue via a puncture needle was technically successful in both patients. No minor or major complication occurred. Both patients disappeared chylothorax after this treatment.
This embolization method can be useful for treatment of chylothorax when conventional TDE is not achievable.
报告经穿刺针直接注射N-丁基-2-氰基丙烯酸酯（NBCA）胶栓塞胸导管的情况。
2例高输出量乳糜胸患者经穿刺针直接注射N-丁基-2-氰基丙烯酸酯（NBCA）胶成功治疗。在这2例患者中，尝试进行传统的胸导管栓塞术（TDE），但在结内淋巴管造影时未见乳糜池，可能因此胸导管插管未成功。然而，经穿刺针注入对比剂清楚显示胸导管有渗漏，促使我们尝试经穿刺针直接注射NBCA胶栓塞胸导管。
2例患者经穿刺针直接注射NBCA胶栓塞胸导管技术均成功。未发生轻微或严重并发症。2例患者经此治疗后乳糜胸均消失。
当无法进行传统胸导管栓塞术时，这种栓塞方法可用于治疗乳糜胸。
