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Transpedal lymphatic embolization for lymphorrhea at the graft harvest site after coronary artery bypass grafting

Yeungnam University Journal of Medicine 2021년 38권 1호 p.74 ~ 77
차중근, 이상엽, 홍지훈, 염헌규, 김갑철, 도영우,
소속 상세정보
차중근 ( Cha Jung-Guen ) - Kyungpook National University Hospital Department of Radiology
이상엽 ( Lee Sang-Yub ) - Kyungpook National University School of Medicine Department of Radiology
홍지훈 ( Hong Ji-Hoon ) - Kyungpook National University Hospital Department of Radiology
염헌규 ( Ryeom Hun-Kyu ) - Kyungpook National University School of Medicine Department of Radiology
김갑철 ( Kim Gab-Chul ) - Kyungpook National University School of Medicine Department of Radiology
도영우 ( Do Young-Woo ) - Kyungpook National University School of Medicine Department of Thoracic and Cardiovascular Surgery

Abstract


Lymphorrhea is a rare but potentially severe complication that occurs after various surgical procedures. Untreated lymphorrhea may lead to wound dehiscence, infection, and prolonged hospital stay. Currently, there is no standard effective treatment. Early management usually includes leg elevation, drainage, and pressure dressing. However, these methods are associated with prolonged recovery and high recurrence rates. We report a case of lymphorrhea from a calf wound after endoscopic great saphenous vein (GSV) harvesting for coronary artery bypass grafting (CABG). The patient presented with intractable oozing from the postoperative wound on the right calf. Lymphorrhea perGsisted for 6 weeks despite negative-pressure wound therapy with a long-acting somatostatin. We performed unilateral pedal lymphangiography that confirmed wound lymphorrhea, followed by glue embolization. No recurrence was observed after 8 months of follow-up. This case report demonstrates the successful use of lymphangiography with glue embolization in the control of lymphorrhea after GSV harvesting for CABG.

키워드

Lymphangiography; Lymphatic system; Therapeutic embolization; Therapeutics

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