← Articles

Davies et al: Lymphaticovenous anastomosis of the caudal thoracic duct to the azygous vein: A feline cadaver study
Veterinary Surgery 7, 2024

🔍 Key Findings

  • Lymphaticovenous anastomosis (TD to AV) was successfully performed in all 8 feline cadavers using a microvascular anastomotic coupler (MAC).
  • Anastomotic patency was confirmed intraoperatively and postoperatively in 7/8 cats via contrast lymphography or retrograde venography.
  • Dissection and anastomosis took a median of 120 minutes, with minimal technical complications.
  • A 1.5 mm MAC was used in 6 cats, and a 2.0 mm in 2 cats; TD diameter ranged 1.0–1.5 mm, AV up to 2.25 mm.
  • Challenges included vessel twisting and luminal patency issues, resolved intraoperatively with minor adjustments (e.g., repeat pinning, tacking suture).
  • MAC use eliminated need for hand-suturing, lowering skill demands but requiring precise alignment.
  • Technique provides direct lymphatic-to-venous drainage, potentially reducing the stimulus for collateral vessel formation.
  • May serve as a future treatment option for feline idiopathic chylothorax, warranting further in vivo studies.

Simini Surgery Review Podcast

How critical is this paper for crushing the Boards?

🚨 Must-know. I’d bet on seeing this.

📚 Useful background, not must-know.

💤 Skip it. Doubt it’ll ever show up.

Thanks for the feedback!
‍We'll keep fine-tuning the articles vault.
Oops — didn’t go through.
‍Mind trying that again?
← Articles

Davies et al: Lymphaticovenous anastomosis of the caudal thoracic duct to the azygous vein: A feline cadaver study
Veterinary Surgery 7, 2024

🔍 Key Findings

  • Lymphaticovenous anastomosis (TD to AV) was successfully performed in all 8 feline cadavers using a microvascular anastomotic coupler (MAC).
  • Anastomotic patency was confirmed intraoperatively and postoperatively in 7/8 cats via contrast lymphography or retrograde venography.
  • Dissection and anastomosis took a median of 120 minutes, with minimal technical complications.
  • A 1.5 mm MAC was used in 6 cats, and a 2.0 mm in 2 cats; TD diameter ranged 1.0–1.5 mm, AV up to 2.25 mm.
  • Challenges included vessel twisting and luminal patency issues, resolved intraoperatively with minor adjustments (e.g., repeat pinning, tacking suture).
  • MAC use eliminated need for hand-suturing, lowering skill demands but requiring precise alignment.
  • Technique provides direct lymphatic-to-venous drainage, potentially reducing the stimulus for collateral vessel formation.
  • May serve as a future treatment option for feline idiopathic chylothorax, warranting further in vivo studies.

Simini Surgery Review Podcast

Join Now to Access Key Summaries to more Veterinary Surgery Articles!
Log InSign Up

Multiple Choice Questions on this study

In Davies 2024 et al., on lymphaticovenous anastomosis, what was used to create the end-to-end connection?

A. Monofilament suture
B. Microsurgical hand-sewn technique
C. Surgical stapler
D. Microvascular anastomotic coupler (MAC)
E. Biologic adhesive

Answer: Microvascular anastomotic coupler (MAC)

Explanation: A commercially available MAC device enabled end-to-end coupling of TD to AV.
In Davies 2024 et al., on lymphaticovenous anastomosis, what intervention resolved partial occlusion of the thoracic duct after MAC coupling in one cat?

A. Flushing with heparin
B. Tacking suture between TD and thoracic wall
C. Use of a larger MAC
D. Inversion of the coupler ring
E. Bypass with a second anastomosis

Answer: Tacking suture between TD and thoracic wall

Explanation: Twisting of the TD was corrected by anchoring it with a tacking suture.
In Davies 2024 et al., on lymphaticovenous anastomosis, what is the proposed advantage of creating a TD to AV anastomosis over traditional TD ligation and cisterna chyli ablation?

A. Improved thoracic visualization
B. Lower intraoperative hemorrhage
C. Reduced need for imaging
D. Direct lymphatic drainage to central veins
E. Enhanced immune cell circulation

Answer: Direct lymphatic drainage to central veins

Explanation: TD to AV connection reduces stimulus for collateral formation and may prevent leakage.
In Davies 2024 et al., on lymphaticovenous anastomosis, which technique confirmed postoperative anastomotic patency in most cadavers?

A. Thoracoscopy
B. Cisterna chyli injection with dye
C. Ultrasound guidance
D. CT angiography
E. Mesenteric contrast lymphography

Answer: Mesenteric contrast lymphography

Explanation: Contrast injected into mesenteric lymph nodes confirmed flow through the TD-MAC-AV pathway.
In Davies 2024 et al., on lymphaticovenous anastomosis, what was the main technical issue encountered during pinning to the MAC?

A. Excessive bleeding from the AV
B. Retrograde flow of venous blood
C. Tearing of the thoracic duct
D. Lack of contrast in imaging
E. Luminal patency difficulty during vessel pinning

Answer: Luminal patency difficulty during vessel pinning

Explanation: Poor luminal visibility required repeat pinning in one cat to ensure flow through the TD.

Elevate Your Infection Control Protocol

Implement Simini Protect Lavage for superior, clinically-proven post-operative skin antisepsis and reduced infection risk.

Start Your Free Trial TodayStart Your Free Trial

Review More Key Summaries from this Veterinary Surgery Journal Issue

Buote

 et al: 

Laparoscopic vertical sleeve gastrectomy in felines: A cadaveric feasibility study and experimental case series in two cats

Adair

 et al: 

Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019)

Ritson

 et al: 

Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips

Ciammaichella

 et al: 

Complications of medial retropharyngeal, axillary, and ilio-sacral lymphadenectomy in 127 dogs with malignant tumors

Downey

 et al: 

Evaluation of long‐term outcome after lung lobectomy for canine non‐neoplastic pulmonary consolidation via thoracoscopic or thoracoscopic‐assisted surgery in 12 dogs