{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:08:04Z","timestamp":1740107284954,"version":"3.37.3"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Intervent Radiol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To report outcomes, procedure\u00a0and\u00a0fluoroscopy times, and adverse event rates after intranodal lymphangiography (IL) and modified IL (mIL) for treatment of traumatic chylous leaks in the thorax\u00a0and\u00a0neck.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Under an IRB-approved protocol, retrospective review of a quality assurance database identified all lymphangiograms for post-surgical refractory chylous leaks in the thorax\u00a0and\u00a0neck at a tertiary center from 2002\u20132022. Records were reviewed for technical\u00a0and\u00a0clinical outcomes, procedure\u00a0and\u00a0fluoroscopy times, and adverse events. Pedal lymphangiograms were excluded. Patients were categorized into IL (pre-2016) and mIL (post-2016) cohorts. mIL incorporated pneumatic calf compression throughout the procedure. Technical success was defined as successful thoracic duct cannulation. Clinical success was defined as leak resolution and eventual\u00a0chest or other drain removal within 2\u00a0weeks post-procedure. A two-tailed Fischer\u2019s exact test was used to compare categorical outcomes. A two-tailed <jats:italic>t<\/jats:italic> test was used to compare means.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Two hundred and thirty-nine patients underwent 263 thoracic duct embolizations of traumatic chylous leaks in the thorax\/neck. Intranodal lymphangiography was used in 167 cases in 150 patients. Overall clinical success was 94.6% [n\u2009=\u2009142\/150]. Technical success was higher in mIL (94.2% [81\/86]) than IL (76.5% [62\/81]) (<jats:italic>p<\/jats:italic>\u2009=\u20090.002). Clinical success per patient and procedure were similar between cohorts (92.3% [72\/78] mIL versus 97.2% [70\/72] IL, <jats:italic>p<\/jats:italic>\u2009=\u20090.27, and 83.7% [72\/86] mIL versus 85.1% [69\/81] IL, <jats:italic>p<\/jats:italic>\u2009=\u20090.83, respectively). Mean procedure time in mIL (83.4\u2009\u00b1\u200931.9\u00a0min) was shorter than in IL (119.2\u2009\u00b1\u200945.9\u00a0min) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Mean fluoroscopy time in mIL (33.8\u2009\u00b1\u200917.3\u00a0min) was shorter than in IL (41.7\u2009\u00b1\u200923.2\u00a0min) (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). Adverse event rate was not significantly different between groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Overall, thoracic duct embolization for traumatic chylothorax has high clinical success, approaching 95%. While clinical success of mIL was similar to IL, technical success and mean procedure and fluoroscopic times were significantly improved. Findings suggest modified intranodal lymphangiography should be utilized to treat traumatic chylothorax.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of Evidence<\/jats:title>\n                <jats:p>Level 4, Case Series.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00270-024-03900-z","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T18:47:58Z","timestamp":1733856478000},"page":"59-64","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Intranodal and Modified Intranodal Lymphangiography for Treatment of Traumatic Chylous Leaks in the Thorax and Neck"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9389-4167","authenticated-orcid":false,"given":"Rupal","family":"Parikh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth R.","family":"Seyferth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Palat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxim","family":"Itkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory J.","family":"Nadolski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"issue":"11","key":"3900_CR1","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1016\/S1051-0443(07)61956-3","volume":"13","author":"C Cope","year":"2002","unstructured":"Cope C, Kaiser LR. Management of unremitting chylothorax by percutaneous embolization and blockage of retroperitoneal lymphatic vessels in 42 patients. J Vasc Interv Radiol. 2002;13(11):1139\u201348. https:\/\/doi.org\/10.1016\/S1051-0443(07)61956-3.","journal-title":"J Vasc Interv Radiol"},{"issue":"4","key":"3900_CR2","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/S1051-0443(95)71134-4","volume":"6","author":"C Cope","year":"1995","unstructured":"Cope C. Percutaneous thoracic duct cannulation: feasibility study in swine. J Vasc Interv Radiol. 1995;6(4):559\u201364. https:\/\/doi.org\/10.1016\/S1051-0443(95)71134-4.","journal-title":"J Vasc Interv Radiol"},{"issue":"6","key":"3900_CR3","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1016\/S0039-6109(16)39008-9","volume":"49","author":"M Pomerantz","year":"1969","unstructured":"Pomerantz M. Lymphangiography. Surg Clin North Am. 1969;49(6):1969.","journal-title":"Surg Clin North Am"},{"issue":"5","key":"3900_CR4","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1016\/j.jvir.2012.01.078","volume":"23","author":"GJ Nadolski","year":"2012","unstructured":"Nadolski GJ, Itkin M. Feasibility of ultrasound-guided intranodal lymphangiogram for thoracic duct embolization. J Vasc Interv Radiol. 2012;23(5):613\u20136. https:\/\/doi.org\/10.1016\/j.jvir.2012.01.078.","journal-title":"J Vasc Interv Radiol"},{"issue":"11","key":"3900_CR5","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1016\/j.jvir.2017.07.035","volume":"28","author":"QC Meisinger","year":"2017","unstructured":"Meisinger QC, O\u2019Brien S, Itkin M, Nadolski GJ. Use of sequential pneumatic compression devices to facilitate propagation of contrast during intranodal lymphangiography. J Vasc Interv Radiol. 2017;28(11):1544\u20137. https:\/\/doi.org\/10.1016\/j.jvir.2017.07.035.","journal-title":"J Vasc Interv Radiol"},{"issue":"10","key":"3900_CR6","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1016\/j.jvir.2017.06.019","volume":"28","author":"O Khalilzadeh","year":"2017","unstructured":"Khalilzadeh O, Baerlocher MO, Shyn PB, Connolly BL, Devane AM, Morris CS, Cohen AM, Midia M, Thornton RH, Gross K, Caplin DM, Aeron G, Misra S, Patel NH, Walker TG, Martinez-Salazar G, Silberzweig JE, Nikolic B. Proposal of a new adverse event classification by the society of interventional radiology standards of practice committee. J Vasc Interv Radiol. 2017;28(10):1432-1437.e3. https:\/\/doi.org\/10.1016\/j.jvir.2017.06.019.","journal-title":"J Vasc Interv Radiol"},{"issue":"2","key":"3900_CR7","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.jvir.2017.10.006","volume":"29","author":"PH Kim","year":"2018","unstructured":"Kim PH, Tsauo J, Shin JH. Lymphatic interventions for chylothorax: a systematic review and meta-analysis. J Vasc Interv Radiol. 2018;29(2):194-202.e4. https:\/\/doi.org\/10.1016\/j.jvir.2017.10.006.","journal-title":"J Vasc Interv Radiol"}],"container-title":["CardioVascular and Interventional Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00270-024-03900-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00270-024-03900-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00270-024-03900-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T10:08:40Z","timestamp":1736330920000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00270-024-03900-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,10]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["3900"],"URL":"https:\/\/doi.org\/10.1007\/s00270-024-03900-z","relation":{},"ISSN":["0174-1551","1432-086X"],"issn-type":[{"type":"print","value":"0174-1551"},{"type":"electronic","value":"1432-086X"}],"subject":[],"published":{"date-parts":[[2024,12,10]]},"assertion":[{"value":"1 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 October 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr. Itkin has received grants, consulting fees, and payments\/honoraria from Guerbet. The remaining authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"For this type of study formal consent is not required. This study has obtained IRB approval from the University of Pennsylvania\u2019s institutional review board and the need for informed consent was waived.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"For this type of study consent for publication is not required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"For this type of study informed consent is not required.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}}]}}