EJVES Vasc Forum. 2026 Oct 19;66:133-136. doi: 10.1016/j.ejvsvf.2026.10.004. eCollection 2026.

ABSTRACT

INTRODUCTION: Inguinal lymphorrhoea is a well recognised complication of vascular surgery that is often refractory to conservative management. Moreover, repeated surgical intervention may increase the risk of wound contamination, recurrent lymphorrhoea, and delayed recovery. This Case Report evaluated the efficacy of lymphangiography and lymphatic embolisation as minimally invasive alternatives for managing refractory post-operative inguinal lymphorrhoea.

REPORT: The cases of four patients (aged 69 - 79 years) who developed refractory lymphorrhoea following arterial procedures, including common femoral artery cannulation and thromboendarterectomy, were reviewed. After conservative treatment or initial surgical management failed, lymphangiography was performed using ultrasound guided intranodal injection of iodised oil. In two patients, lymphatic embolisation was additionally performed using n-butyl-2-cyanoacrylate diluted with iodised oil in a ratio at 1:3 to 1:4. Fluoroscopic guidance enabled precise localisation of lymphatic leakage points. Lymphatic drainage was maintained using a pigtail catheter with continuous negative pressure. Lymphorrhoea resolved in all patients, and drainage catheters were removed within three - 13 days. No recurrence was observed during 10 - 30 months of follow up.

DISCUSSION: Lymphangiography and lymphatic embolisation may be effective, minimally invasive therapeutic options for refractory post-operative inguinal lymphorrhoea. These procedures facilitate the precise localisation and closure of lymphatic leaks, shorten recovery time, and help avoid surgical re-exploration of the groin and its associated risks.

PMID:43032769 | PMC:PMC13762950 | DOI:10.1016/j.ejvsvf.2026.10.004