2.3.2 Endovascular Interventions
Expertise of Interventional radiology (IR) and other interventional
specialties (ex. cardiology, neurosurgery) is frequently necessary in
the multimodal treatment approach of CLA. IR expertise is needed for
lymphoscintigraphy and MR lymphangiography. Lymphoscintigraphy provides
dynamic information on flow of lymphatic fluid but lacks spatial
resolution and anatomic details. MR lymphangiography provides dynamic
and anatomical information of the lymphatic vasculature and can also
allow for therapeutic intervention. Progressive accumulation of contrast
material followed by slow dispersion into the pleural and/or pericardial
spaces helps identify the source of effusions. If a specific area of
leakage is found, then embolization with ethiodized oil (Lipiodol)
injection is a therapeutic option. Sclerotherapy is also a treatment
option for macrocystic and microcystic LM. Sclerotherapy is used to
reduce size of LM, improve pain, and decrease complications like
frequent infections or bleeding into the cysts.