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

• Published in: Journal of yeungnam medical science Vol. 38; no. 1; pp. 74 - 77
• Main Authors: Cha, Jung Guen, Lee, Sang Yub, Hong, Jihoon, Ryeom, Hun Kyu, Kim, Gab Chul, Do, Young Woo
• Format: Journal Article
• Language: English
• Published: Korea (South) Yeungnam University College of Medicine 01.01.2021; 영남대학교 의과대학
• Subjects: Case Report; lymphangiography; lymphatic system; therapeutic embolization; therapeutics; 의학일반; Lymphatic system; Therapeutic embolization; Lymphangiography; Therapeutics
• ISSN: 2384-0293; 2384-0293; 2799-8010
• DOI: 10.12701/yujm.2020.00297

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.