PERCUTANEOUS TRANSTHORACIC DUCT CATHETERIZATION TO THE NECK AND ESOPHAGUS - A FEASIBILITY STUDY

PURPOSE: To assess the feasibility of inserting a drain catheter percu taneously from the cisterna chyli (CC) through the thoracic duct (TD) wall to the neck or esophagus for potential long-term T-cell sampling or drainage in acute or short-term experiments, MATERIALS AND METHODS: Percutaneous transabdominal catheterization of the TD from the CC was performed in four animals to insert a 65-cm, al-gauge needle over a m icroguidewire. In two dogs, the distal TD was perforated into the neck to connect the TD drain to an access port, In acute experiments on tw o swine, the esophagus was accessed by puncturing an intraluminal Fole y-catheter balloon through the mid TD wall, In one animal, the TD cath eter tip was left to drain in the distal esophagus; in the other anima l, the catheter distal tip was pulled back through a gastrostomy until the proximal end had retracted into the proximal TD, RESULTS: TD-to-n eck port connection was well tolerated shortterm, One dog developed de hiscence over the port at 10 days necessitating its removal; in the ot her dog, the whole drain retracted into the neck from the proximal TD, The technique for TD-to-esophagus catheterization in swine was feasib le with no acute complications or mediastinal leakage of contrast medi um, CONCLUSIONS: Transabdominal percutaneous inside-out TD puncture fo r drainage to a neck port or to the esophagus is feasible in dogs and swine, respectively.