“…Traditionally, thoracic duct embolization was performed through transabdominal approach, consisting of pedal lymphangiography, direct transabdominal catheterization of cisterna chyli and subsequently, antegrade catheterization of thoracic duct (Cope & Kaiser, 2002). However, this was technically challenging particularly in patients with obesity or deep inspiratory efforts, with a slight potential risk for injury to visceral organs (Guevara et al, 2016;Itkin & Chen, 2011) Over time, to overcome the challenges, different techniques such as retrograde approach have been developed where access is obtained in basilic, brachial, or even femoral vein and thoracic duct is catheterized via the lymphovenous junction (Kariya et al, 2018). In this case, we did not use retrograde thoracic duct access at the lymphovenous junction using venous access.…”