Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Transpedal lymphatic embolization for lymphorrhea at the graft harvest site after coronary artery bypass grafting

  • Cha, Jung Guen (Department of Radiology, Kyungpook National University Hospital) ;
  • Lee, Sang Yub (Department of Radiology, School of Medicine, Kyungpook National University) ;
  • Hong, Jihoon (Department of Radiology, Kyungpook National University Hospital) ;
  • Ryeom, Hun Kyu (Department of Radiology, School of Medicine, Kyungpook National University) ;
  • Kim, Gab Chul (Department of Radiology, School of Medicine, Kyungpook National University) ;
  • Do, Young Woo (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University)
  • Received : 2020.04.26
  • Accepted : 2020.06.23
  • Published : 2021.01.31
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Abstract

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 persisted 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.

Keywords

Acknowledgement

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF- 2017R1C1B5075931).

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