Delayed complications following technically successful thoracic duct embolization

J Vasc Interv Radiol. 2012 Jan;23(1):76-9. doi: 10.1016/j.jvir.2011.10.008. Epub 2011 Nov 23.


Purpose: Thoracic duct (TD) embolization (TDE) has become a universally accepted treatment of chylous pleural effusion. However, the long-term sequelae of occlusion of the TD are unknown. The objective of the present study was to determine the rate of delayed complications after technically successful TDE.

Materials and methods: A total of 169 patients underwent TDE for symptomatic chylous effusion between January 1, 1994, and June 11, 2010. In 106 of 169 cases (63%), TDE embolization was technically successful. Retrospective review of these charts was performed, and patients were interviewed to determine the development of lower-extremity edema, diarrhea, abdominal swelling, and other symptoms.

Results: Follow-up information was available in 78 of 106 patients (73.6%). Mean length of follow-up was 34 months. During follow-up, 32 patients (41%) died of causes unrelated to TDE, and 46 (59%) were alive at the end of follow-up. The families of three deceased patients were available for interview. Four of 49 patients (8%) had chronic leg swelling that was probably related to the procedure, three (6%) had abdominal swelling, and six (12%) had chronic diarrhea. In four of these six cases, diarrhea was considered "probably related" to the procedure. Overall, a 14.3% rate of probably-related long-term complications after TDE was recorded.

Conclusions: Chronic diarrhea and lower-extremity swelling may be related to TDE and should be part of informed consent before the procedure. A prospective follow-up study is needed to further establish these relationships.

MeSH terms

  • Adult
  • Aged
  • Chylothorax / etiology
  • Chylothorax / therapy*
  • Embolization, Therapeutic / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Surveys and Questionnaires
  • Survival Rate
  • Thoracic Duct*
  • Treatment Outcome