Lymphatic embolization (CME) – online course

Description

Authors: L. Ratnam and G. Maleux

Reviewers: F. Basilico, T. Bilhim, C. Loberg, C. Nice, S. Punamiya, A. Ryan and R. Uberoi

This course corresponds to chapter 2.2.2.2 Lymphatic embolization in the European Curriculum and Syllabus for Interventional Radiology.

Abstract

Imaging of the lymphatic system was traditionally carried out by pedal lymphangiography (which involved exposing and cannulating the lymphatic channels on the dorsum of the foot and injecting lipiodol followed by fluoroscopic tracking of the contrast up the leg) or lymphoscintigraphy (use of radionuclide injected into the interstitial tissues and tracing uptake). The former process is time consuming and technically challenging. The latter provides poor anatomical detail. With the advances in cross-sectional imaging, pedal lymphangiography fell out of favour; however, the advent of intranodal MR lymphangiography and, more recently, CT lymphangiography has revived interest in the lymphatic system. This imaging revolution has also brought about a raft of new interventional techniques to treat lymphatic leakage including thoracic duct embolization, glue embolization of interstitial lymphatic leaks, and providing imaging guidance to assist novel surgical techniques including microvascular lympho-venous anastomoses. A thorough understanding of the anatomy of the lymphatics, indications and contraindications, and the range of treatment options available are crucial to providing good interventional radiological support for the care of patients with lymphatic leaks and primary lymphatic disorders.

Learning objectives

• Describe the drainage pathway for the lymphatic system.
• Explain different imaging techniques to identify lymphatic leaks.
• List the clinical presentations and common causes of lymphatic leaks.
• Describe the techniques available for treating lymphatic leaks.
• Know the equipment commonly used to undertake lymphangiography and describe the principles of US-guided lymph node puncture to undertake lymphangiography.
• Describe the technique for lymphatic duct/cisterna chyli puncture and embolization of the lymphatics and know the commonly used embolic agents for lymphatic embolization.

Further information

This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for Interventional Radiology and corresponds to chapter 2.2.2.2 Lymphatic embolization.

The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one and a half hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1.5 European CME credits (ECMEC). The CME accreditation for this course will expire on March 31, 2027. A non-CME accredited version of the course will remain available until March 31, 2029.

The enrolment period of this course is linked to the validity of the All-Access Pass.

Release date: March 2025