Embolization of the Thoracic Duct by Direct Injection of N -Butyl-2-Cyanoacrylate Glue via a Puncture Needle

Purpose To report embolization of the thoracic duct by direct injection of N-butyl-2-cyanoacrylate (NBCA) glue via a puncture needle. Materials and Methods Two cases of high output chylothorax were successfully treated with direct injection of N-butyl-2-cyanoacrylate (NBCA) glue via a puncture needle. In them, conventional thoracic duct embolization (TDE) was attempted, but the cisterna chyli was absent on intranodal lymphangiography, and probably for this reason catheterization of the thoracic duct was unsuccessful. Contrast material injection via a puncture needle, however, clearly showed a leak from the thoracic duct, prompting us to attempt embolization of the thoracic duct by direct injection of NBCA glue via the needle. Results Thoracic duct embolization by direct injection of NBCA glue via a puncture needle was technically successful in both patients. No minor or major complication occurred. Both patients disappeared chylothorax after this treatment. Conclusion This embolization method can be useful for treatment of chylothorax when conventional TDE is not achievable.