Percutaneous thoracic duct cannulation: feasibility study in swine

Abstract

Purpose: To assess the feasibility of percutaneous catheterization of the thoracic duct (TD) in 15 pigs.

Materials and methods: After opacification of the cisterna chyli (CC) with pedal lymphography, the CC is punctured transabdominally with a 21-gauge needle and the TD is catheterized with a 3-F catheter over a guide wire. For retrograde TD catheterization, the guide wire is advanced cephalad to a neck vein, snared, retrieved through the jugular or femoral vein, and used to insert a catheter retrogradely through the lymphovenous junction. The transabdominal wire is removed.

Results: Of 15 pigs studied, successful TD catheterization was performed in 13 (antegrade [n = 4], antegrade-retrograde [n = 9]). Two failures were due to CC anomalies. No acute complications were noted. A marker was left in the CC, and TD catheterization was repeated in two pigs, 2 and 5 days later.

Conclusions: Percutaneous transabdominal TD catheterization in the swine is feasible, safe, and repeatable. This technique has potential clinical applications in organ transplantation and management of TD laceration.