Retrograde Cannulation of the Thoracic Duct and Embolization of the Cisterna Chyli in the Treatment of Chylous Ascites

The authors offer a previously undescribed technique for cisterna chyli embolization in the treatment of chylous ascites. After the failure of conventional percutaneous direct cisterna chyli cannulation, the authors accessed the thoracic duct directly from the subclavian vein. Retrograde microcatheter access through the thoracic duct enabled embolization of the cisterna chyli. Embolization materials included fibered endovascular coils, gelatin sponge, and doxycycline. The patient's symptoms returned 10 days after embolization. This technique provided short-term success in the treatment of the patient's chylous ascites.