Hoa Tran Quoc, Cuong Nguyen Ngoc, Hoan Le, Hoang Nguyen, Long Hoang, Luu Doan Tien, Hoan Nguyen Cong
Surgery Urology, Hanoi Medical University Hospital, Hanoi, Vietnam.
Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam.
CVIR Endovasc. 2023 Aug 7;6(1):39. doi: 10.1186/s42155-023-00387-6.
Thoracic duct (TD) stenting is considered a treatment option for certain pathological conditions caused by TD obstruction, such as chyluria. Several studies have reported on the efficacy of TD stent treatment for both obstructive and leakage condition of TD, but few have evaluated the stent patency. This report aims to describe the patency of TD stent and the effectiveness of renal-lymphatic fistula embolization in the treatment of chyluria.
We report a case of chyluria treated by TD stent previously, stent was placed at the TD venous junction four months before the symptoms recurred. At the second intervention we found the stent was obstructed by debris. We recanalized the stent and successfully catheterised the microcatheter through the stent retrograde into the TD then into the renal-lymphatic fistula branch. After embolization of that abnormal branch, the recurrent chyluria was treated and no further episode of chyluria was occurred during 12 months follow up.
Stent in the TD may be occluded by debris. Embolization of renal-lymphatic fistula might be the most important treatment for spontaneous chyluria.
胸导管（TD）支架置入术被认为是治疗由TD梗阻引起的某些病理状况的一种治疗选择，如乳糜尿。几项研究报道了TD支架治疗TD梗阻和渗漏状况的疗效，但很少有研究评估支架通畅性。本报告旨在描述TD支架的通畅性以及肾淋巴管瘘栓塞术治疗乳糜尿的有效性。
我们报告1例曾接受TD支架治疗的乳糜尿病例，在症状复发前4个月于TD静脉交界处放置支架。在第二次干预时，我们发现支架被碎片阻塞。我们重新开通支架，并成功地将微导管通过支架逆行插入TD，然后进入肾淋巴管瘘分支。栓塞该异常分支后，复发性乳糜尿得到治疗，在12个月的随访期间未再出现乳糜尿发作。
TD内的支架可能被碎片阻塞。肾淋巴管瘘栓塞术可能是自发性乳糜尿的最重要治疗方法。
