초록접수 현황
| 20F-027 | 포스터 발표 |
Efficacy of Iopamidol for Sealing Injured Thoracic Duct: Experiments in a Large Animal
Ho Seong Cho1; Hyo Yeong Ahn1; Seunghwan Song1; Up Huh1*; Il Jae Wang2; Jung Seop Eom3; and Dong-Man Ryu4
1Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
2Department of Emergency Medicine, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
3Division of Respiratory, Department of Internal Medicine, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
4 Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
Purpose : Chylothorax has been spontaneously healed by lymphangiography performed using lipiodol, but pulmonary or systemic embolization is a potential complication. We aimed to determine the efficacy of iopamidol as an alternative to lipiodol in treating chylous leakage using an animal model.
Methods : Twelve pigs were divided into two groups of six each; after induction of thoracic duct damage, groups A and B were injected with iopamidol and lipiodol, respectively, into the thoracic duct. At 5, 10, and 30 min after damage induction, the effects were monitored by video-assisted thoracoscopy and lymphangiography. In vitro, chyle samples from the pigs were incubated with iopamidol and lipiodol. After the treatments, the damaged thoracic duct was harvested from pigs in group A and examined under a microscope.
Results : In group A, 4 and 2 pigs had no chylous leakage after 5 and 10 min, respectively. In group B, chylous leakage was not observed in any of the pigs after 5 min. In vitro, both iopamidol- and lipiodol-treated chyle started to adhere after 5 min and solidified at 30 min. Histological findings confirmed that the damaged thoracic duct was clogged with an amorphous proteinaceous material (iopamidol).
Conclusion : This study showed the potential of iopamidol as a new therapeutic agent for chylous leakage. Failure of thoracic duct embolization or a risk of systemic embolization due to lipiodol injection could be avoided by injecting iopamidol through the thoracic duct, which might be safe and worth further investigation.
Methods : Twelve pigs were divided into two groups of six each; after induction of thoracic duct damage, groups A and B were injected with iopamidol and lipiodol, respectively, into the thoracic duct. At 5, 10, and 30 min after damage induction, the effects were monitored by video-assisted thoracoscopy and lymphangiography. In vitro, chyle samples from the pigs were incubated with iopamidol and lipiodol. After the treatments, the damaged thoracic duct was harvested from pigs in group A and examined under a microscope.
Results : In group A, 4 and 2 pigs had no chylous leakage after 5 and 10 min, respectively. In group B, chylous leakage was not observed in any of the pigs after 5 min. In vitro, both iopamidol- and lipiodol-treated chyle started to adhere after 5 min and solidified at 30 min. Histological findings confirmed that the damaged thoracic duct was clogged with an amorphous proteinaceous material (iopamidol).
Conclusion : This study showed the potential of iopamidol as a new therapeutic agent for chylous leakage. Failure of thoracic duct embolization or a risk of systemic embolization due to lipiodol injection could be avoided by injecting iopamidol through the thoracic duct, which might be safe and worth further investigation.
책임저자: Hyo Yeong Ahn
Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
발표자: Ho Seong Cho, E-mail : helyer@naver.com