Quarterly update

with Social Media Editor Sara Lojo

Dr. Sara Lojo is passionate about interventional radiology and has been involved in the editorial board of many publications since her training. She considers editorialism to be a fundamental tool for training, encouraging its development and bringing it closer to the new generations of IR professionals.

In this Quarterly Update, she will highlight key issues in IR and accompanying CVIR Endovascular articles on the topic.

Dr. Sara Lojo is passionate about interventional radiology and has been involved in the editorial board of many publications since her training. She considers editorialism to be a fundamental tool for training, encouraging its development and bringing it closer to the new generations of IR professionals.

In this Quarterly Update, she will highlight key issues in IR and accompanying CVIR Endovascular articles on the topic.

Quarterly Update #7: Lymphatics

Published on June 2025

The lymphatic system, once considered a challenging frontier in interventional radiology (IR), has rapidly emerged as a vital focus of minimally invasive therapies. Lymphatic leaks—including chylothorax, chylous ascites, and postoperative lymphatic fistulas—pose significant clinical challenges, often resulting in prolonged hospitalizations, nutritional deficits, and increased morbidity. Traditionally managed through conservative measures or complex surgery, these conditions are now increasingly treated with image-guided interventions that offer precision, safety, and reduced invasiveness.

Innovative techniques such as intranodal lymphangiography (ILAG), thoracic duct embolization (TDE), and transnodal embolization (TNE) have demonstrated high rates of technical and clinical success. ILAG, in particular, is gaining prominence as a first-line diagnostic and therapeutic tool, enabling detailed visualization of lymphatic anatomy and targeted treatment planning. Moreover, advancements in iodized oil-based lymphangiography and post-procedural CT imaging are enhancing the ability to tailor interventions to the specific site and type of leak.

As IR continues to expand its clinical scope, standardization of lymphatic procedures and training protocols is essential. This not only ensures consistent outcomes but also promotes wider adoption of these techniques in managing lymphatic complications. The evolution of lymphatic interventions exemplifies the adaptability and innovation of interventional radiology in addressing complex post-surgical and iatrogenic conditions, reinforcing its integral role in modern multidisciplinary care.

Articles

Lymphatic leaks - success of intranodal lymphangiogram first strategy

Alan Campbell, Diana Velazquez-Pimentel, Matthew Seager, Richard Hesketh, Julian Hague, Jowad Raja, Jocelyn Brookes, An Ngo, Miles Walkden, Anthie Papadopoulou, Daron Smith, Borzoueh Mohammadi, Ravi Barod, Mohammed Rashid Akhtar, Jimmy Kyaw Tun, Deborah Elise Low, Ian Daniel Renfrew, Tim Fotheringham & Conrad von Stempel

Standardizing lymphangiography and lymphatic interventions: a preclinical in vivo approach with detailed procedural steps

Feng Pan, Thuy D. Do, Niclas Schmitt, Dominik F. Vollherbst, Markus Möhlenbruch, Parham Tinoush, Alexander Brobeil, Vitali Koch, Götz M. Richter, Philippe L. Pereira, Hans U. Kauczor & Christof M. Sommer

Interventional solutions for post-surgical problems: a lymphatic leaks review

Fernando M. Gómez, Tarik R. Baetens, Ernestos Santos, Boris León Rocha, Benjamín Horwitz, Sara Lojo-Lendoiro, Patricio Vargas, Premal Patel, Regina Beets-Tan, José J. Martínez-Rodrigo & Luis Martí Bonmatí