Welker et al: Anastomosis of the caudal thoracic duct and intercostal vein using a microvascular anastomotic coupler device: Experimental study in six dogs
Veterinary Surgery 7, 2024

🔍 Key Findings

• Anastomosis of the thoracic duct (TD) to the intercostal vein (ICV) using a microvascular anastomotic coupler (MAC) was feasible in all 6 healthy dogs
• Immediate postoperative patency was confirmed in all dogs, but only 4/6 had patent anastomoses at 30 days, with 2 failing due to ICV kinking
• Kinking of the ICV near the azygos vein insertion was the primary failure mechanism, likely from MAC malalignment
• No intraoperative or major postoperative complications occurred, though 2 dogs developed mild seromas
• Use of the MAC device simplified microsurgical anastomosis versus hand suturing, especially in the deep thoracic cavity
• Contrast lymphangiography showed faster clearance from the cisterna chyli postoperatively, suggesting effective flow redirection
• Persistent branches of the thoracic duct may impact outcomes, and should be ligated during surgery
• This technique may be a potential novel treatment for idiopathic chylothorax, improving outcomes by reducing collateral flow stimuli