In this educational exhibit,
the role of transpedal lymphangiography and different percutaneous lymphatic second-line interventions with intention to cure post-operative therapy-refractory lymphatic fistula in the groin region is outlined.
Technical and clinical aspects are presented in the form of a pictorial essay.
Post-operative therapy-refractory lymphatic fistula in the groin region is a therapeutic challenge [1-4].
Affected patients suffer from a reduced quality of life (e.g.
due to wound healing disorders) and are subject to risk from life-threatening comorbidity (e.g.
due to malnutrition and immunodeficiency) ( Figure 1 ) .
different time-consuming and often cost-intensive and clinically ineffective medical and surgical treatments are performed before specific radiological lymphatic...
Findings and procedure details
Transpedal lymphangiography: Transpedal lymphangiography applying iodized oil as contrast and occlusion material and radiography and CT as imaging modalities is the first-line approach to visualize type (e.g.
lymphopseudoaneurysm or lymphocele),
unifocal or multifocal) and exact location (e.g.
efferent to lymph nodes) of post-operative therapy-refractory lymphatic fistula in the groin region.
The major steps of transpedal lymphangiography -includingpreparation,
Transpedal lymphangiography and different percutaneous lymphatic second-line interventions are feasible,
and effective to cure post-operative therapy-refractory lymphatic fistula in the groin region.
The radiological treatment should be indicated in the early post-operative course with intention to minimize physical and mental suffering of patients,
and additionallyto decrease healthcare provider costs.
Corresponding Author Christof M Sommer,
MD Stuttgart Clinics Clinic for Diagnostic and Interventional Radiology Kriegsbergstrasse 60 70174 Stuttgart Germany Phone: +49 (0)711 27834400 Fax: +49 (0)711 27834409 Email firstname.lastname@example.org / University Hospital Heidelberg Clinic for Diagnostic and Interventional Radiology INF 110 69120 Heidelberg Germany Phone:+49 (0)6221 5638534 Fax:+49 (0)6221 564194 Email email@example.com
Lee M et al : Early Experience in the Management of Postoperative Lymphatic Leakage Using Lipiodol Lymphangiography and Adjunctive Glue Embolization . Journal of vascular and interventional radiology : JVIR 2016, 27 (8):1177-1186 e1171. Inoue M,
Jinzaki M: Lymphatic Intervention for Various Types of Lymphorrhea: Access and Treatment . Radiographics : a...