Occlusion of thoracic duct stent resulting in recurrent chyluria: role of renal-lymphatic fistula embolization

Abstract

Background 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. Case presentation 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. Conclusion Stent in the TD may be occluded by debris. Embolization of renal-lymphatic fistula might be the most important treatment for spontaneous chyluria.

Central Lymphatic Imaging in Adults with Spontaneous Chyluria

“…13 Conversely, the recurrence of chyluria was observed when the stent became obstructed. 14 This study represents the largest cohort reported on the application of MRL and IL in patients with chyluria.…”