Guidelines

Lipiodol^® Ultra-Fluid
(Iodinated ethyl esters of fatty acids of poppy seed oil)

Lymphography procedure’s guidelines

Lymphography – Detecting lymphatic system impairment recommended by International Clinical Guidelines

International Union IUA Guideline (International Union of Angiology)(9)

« Oil contrast standard Lymphangiography /Lymphography
LAG* is still advantageously employ in selected patients with chylous dysplasia and gravitational reflux disorders in order to define more clearly the extension of the pathologic alteration and site of lymphatic and chylous leak. These are the only diagnostic investigation that can clearly demonstrate pathologies of chylous vessels, chylous cyst and thoracic duct in cases of chylothorax, chylous ascites, protein losing enteropathy.»

*LAG: Lymphangiography

American APTA Guideline(10) (American Physical Therapy Association)

« …Lymphography may be used to detect lymphatic system impairment… Diagnostic accuracy in patients with known lymphedema demonstrated a sensitivity of 1.0 and a specificity of 1.0 when compared with CT and MRI…»

Lipiodol^{^®} Ultra-Fluid (Iodinated ethyl esters of fatty acids of poppy seed oil) used for lymphangiography/lymphography endorsed by international guideline

International Union IUA Guideline(9) (International Union of Angiology)

« A lipid-soluble ultrafluid contrast medium (Lipiodol^® Ultra fluid) is injected into lymphatic vessel after isolation and cannulation of the lymphatics of the dorsum of foot with microsurgical technique so that the lymphatic network and lymph nodes can be seen.

…When this conventional oil contrast lymphangiography is coupled with CT scan, it allows a more accurate assessment of disease extension, as well as the site of the obstacle and source of chylous leakage.
The main indications for the use of direct oil contrast lymphangiography are represented by the pre-operative assessment of patients affected by lymphatic and chylostatic disorders: chyloperitoneum chylothorax, chyluria, chylo-colpometrorrhea, and chylous joint effusion.»

Learn more about the clinical cases related to interventional radiology

Clinical Cases and Publications

References

^{1.EASL-EORTC Clinical Practice Guidelines for the Management of Hepatocellular Carcinoma. J. Hepatol. 2018}

^{2.ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (eUpdate), 2020, https://www.esmo.org/guidelines/gastrointestinal-cancers/hepatocellular-carcinoma}

^{3.US Guidelines: Bruix J. AASLD Practice Guidelines; American Association for Study of the Liver Diseases; Hepatology 2011; Vol. 53, No. 3.}

^{4.Japanese Guidelines: Hepatology Research 2010; 40 (Suppl. 1): 96–112.}

^{5.Chinese guidelines 2011 edition, Chin. Clin. Oncol. 2012; 1:10.}

^{6.Takeuchi Y. et al., Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition, Jpn J Radiol, 2014; 32:500–517.}

^{7.American Society for Gastrointestinal Endoscopy. Tissue adhesives: cyanoacrylate glue and fibrin sealant, Gastrointestinal Endoscopy, 2013;78: 2. 209-215.}

^{8.LEE BB. et al., Consensus Document of the International Union of Angiology (IUA)-2013 Current concepts on the management of arterio-venous malformations, International Angiology, 2013;32(1):11-36.}

^{9.Lee BB, et al., IUA-ISVI consensus for diagnosis guideline of chronic lymphedema of the limbs, Edizioni Minerva Medica, 2014,https://www.minervamedica.it/}

^{10.Kimberly Levenhagen, et al., Diagnosis of Upper-Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of APTA, American Physical Therapy Association, Phys Ther, 2017;97: 729–745}

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