A new, minimally-invasive procedure is helping children and adolescents with lymphatic leaks find their path to recovery faster and safer than ever before.
Leaks within the lymphatic system cause shortness of breath, fatigue, electrolyte abnormalities, and can be fatal if left untreated.
According to James Chen, MD, Interventional Radiologist with Charlotte Radiology, who treats patients at Atrium Health's Levine Children's Hospital , the lymphatic embolization procedure has been steadily evolving over the past 10 years — and now, it’s available for our pediatric patients.
First children’s hospital in the region to offer innovative embolization procedure
“With this new procedure, we have a unique opportunity to provide a more reliable, safer treatment to those suffering from these types of illnesses,” says Dr. Chen.
The lymphatic system removes toxins and transports lymph fluid throughout the body. When that circulation is thrown off balance, the immune system becomes compromised.
“Your body makes 2.4 liters of lymphatic fluid a day,” he says. “So if you have a leak, a large volume of fluid can accumulate in the chest or abdomen.”
Left untreated, patients with lymphatic leaks can experience dangerous levels of fluid build up, compressing the lungs and causing severe shortness of breath.
“Without the lymphatic embolization procedure, it can be very challenging to get this leakage to stop,” says Dr. Chen. “Medications can take a while, and patients usually have to undergo hospitalization and the insertion of chest tubes — some children do not have improvement in the leakage despite these medical therapy methods.”
Lifesaving procedure for babies born with rare, potentially fatal defects
Dr. Chen says the procedure can be lifesaving for children born with congenital chylous fluid buildup — or leaking of lymphatic fluid — into the chest or abdomen.
“Congenital chyle leaks are associated with certain genetic disorders, but can also occur in isolation,” said Dr. Chen. “As a result of prolonged lymphatic fluid losses into the chest or abdomen, children start to lose nutrition and the ability to fight off infections.”
Lymphatic embolization also helps patients who develop lymphatic leaks following surgeries on the chest or heart, adds Dr. Chen.
Higher success rates, faster recovery
Prior surgeries for lymphatic leaks were more invasive, according to Dr. Chen. And despite undergoing surgical thoracic duct ligation, around 20% of patients had to return for repeat surgeries because the leaks continued.
“But with this new procedure, we’ve seen a success rate upwards of 90% — significantly higher than ever before,” said Dr. Chen.
How does the procedure work?
Dr. Chen breaks down the steps involved in a typical embolization procedure:
- Lymphography. A contrast dye extracted from poppy seed oil is inserted into the lymph nodes, enabling physicians to map out the lymphatic system and pinpoint the area of leakage. “The dye is thick so injecting it alone helps to slow or stop leaks,” adds Dr. Chen.
- Embolization . Depending on the case, the surgeon perform either a thoracic duct embolization (using a coil and glue to block the leak) or thoracic duct disruption. The end goal in both types of procedures is to fix and close the leak.
- Recovery. According to Dr. Chen, the procedure typically takes about one to two hours to complete. Following surgery, patients remain in the hospital to recover from anesthesia. Once the leakage stops and chest tubes are able to be taken out, patients are discharged and essentially healed.
“This new procedure presents a wonderful new opportunity to treat patients right here at Atrium Health Levine Children’s Hospital,” he says. “As medicine and technology continue to evolve, so will advancements in the ways we’re able to treat patients with lymphatic leaks.”
