Experience in the management of lymphatic leakage using lipiodol lymphangiography and a temperature-sensitive liquid agent embolization.

Objective: Evaluate the safety and efficacy of a temperature-sensitive liquid embolic agent in the management of lymphatic leakage. Methods: Patients with lymphatic leakage who underwent interventional treatment in our center from September 2023 to April 2025 were retrospectively analyzed. The patient underwent percutaneous inguinal lymph node puncture, and iodized oil was used for lymphography. After lymphography, Chiba needle was used to puncture the breach under the guidance of DSA or CT, and temperature-sensitive liquid embolic agent (TempSLE) was used for direct injection embolization. The drainage volume or urine volume was mainly observed after procedure. The clinical success rate was defined as chest and abdominal drainage volume less than 100 mL/ day or urine chylous test negative for 3 consecutive days. Results: A total of 44 patients were included in this study. The main symptoms were chylous ascites in 26 cases, chylothorax in 12 cases, chylopericardium in 2 cases, and chyluria in 4 cases. Twenty-two patients had lymphatic leakage after surgical operation, mainly including Whipple procedures, spinal internal fixation and gynecological surgery. The remaining 22 cases were unexplained and spontaneous lymphatic leakage. Lipiodol lymphography was successfully performed in 44 patients, and embolization of lymphatic vessels using TempSLE were performed in 26 patients. The technique success rate was 100%, and clinical effective rate was 55.6% (lymphography alone group) and 84.6% (TempSLE group). No major complications were found in both groups. Conclusions: The application of temperature-sensitive liquid embolic agent (TempSLE) in the treatment of lymphatic leakage was safe and promising.