Korean J Radiol.  2020 Mar;21(3):298-305. 10.3348/kjr.2019.0313.

A Canine Model for Lymphangiography and Thoracic Duct Access

Affiliations
  • 1Department of Radiology and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
  • 2Biomedical Engineering Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
  • 4Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jhshin@amc.seoul.kr
  • 5Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.

Abstract


OBJECTIVE
To evaluate the technical feasibility of intranodal lymphangiography and thoracic duct (TD) access in a canine model.
MATERIALS AND METHODS
Five male mongrel dogs were studied. The dog was placed in the supine position, and the most prominent lymph node in the groin was accessed using a 26-gauge spinal needle under ultrasonography (US) guidance. If the cisterna chyli (CC) was not opacified by bilateral lymphangiography, the medial iliac lymph nodes were directly punctured and Lipiodol was injected. After opacification, the CC was directly punctured with a 22-gauge needle. A 0.018-in microguidewire was advanced through the CC and TD. A 4-Fr introducer and dilator were then advanced over the wire. The microguidewire was changed to a 0.035-in guidewire, and this was advanced into the left subclavian vein through the terminal valve of the TD. Retrograde TD access was performed using a snare kit.
RESULTS
US-guided lymphangiography (including intranodal injection of Lipiodol [Guerbet]) was successful in all five dogs. However, in three of the five dogs (60%), the medial iliac lymph nodes were not fully opacified due to overt Lipiodol extravasation at the initial injection site. In these dogs, contralateral superficial inguinal intranodal injection was performed. However, two of these three dogs subsequently underwent direct medial iliac lymph node puncture under fluoroscopy guidance to deliver additional Lipiodol into the lymphatic system. Transabdominal CC puncture and cannulation with a 4-Fr introducer was successful in all five dogs. Transvenous retrograde catheterization of the TD (performed using a snare kit) was also successful in all five dogs.
CONCLUSION
A canine model may be appropriate for intranodal lymphangiography and TD access. Most lymphatic intervention techniques can be performed in a canine using the same instruments that are employed in a clinical setting.

Keyword

Lymphangiography; Lymphatic intervention; Canine; Thoracic duct; Cisterna chyli

MeSH Terms

Animals
Catheterization
Catheters
Dogs
Ethiodized Oil
Fluoroscopy
Groin
Humans
Lymph Nodes
Lymphatic System
Lymphography*
Male
Needles
Punctures
SNARE Proteins
Subclavian Vein
Supine Position
Thoracic Duct*
Ultrasonography
Ethiodized Oil
SNARE Proteins
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