Calcified Fibrin Sheath Masquerading as Retained Catheter

Lu, Albert; Smith, Douglas C.

doi:10.1016/j.jvir.2012.01.071

Cited by 6 publications

(6 citation statements)

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“…5 However, it is a very rare complication which has been previously reported only few times. 5–10 Specifically, dialysis catheters are typically placed for longer periods and are large-bore catheters; thus, are more likely to injure the venous wall.…”

Section: Introductionmentioning

confidence: 99%

Presence of retained calcified fibrin sheath after central venous catheter removal: A systematic literature review

Matusik¹,

Łoboda²,

Kościelska‐Kasprzak

et al. 2020

J Vasc Access

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Central venous catheters (CVC) are used in many clinical settings for a variety of indications. We performed a systematic literature review concerning case reports of retained calcified fibrin sheaths after dialysis CVC removal. The aim of our study was to systematize the knowledge regarding clinical management of this phenomenon, placing special emphasis on diagnostic radiological features in different imaging modalities, including chest radiography, echocardiography, computed tomography, and magnetic resonance imaging. We discuss the most common risk factors associated with this CVC complication. In our review, we found eight cases of hemodialysis patients. The most common risk factors associated with calcified fibrin sheath formation in the analyzed cases were pro-thrombotic and pro-calcification factors related to patient comorbidities, and prolonged catheter dwell time. Differentiating between a calcified fibrin sheath (present in about 6% of patients with long-term indwelling CVC as diagnosed by computed tomography) and a retained catheter tip can be challenging. The initial diagnosis based on imaging methods was incorrect in most of the analyzed cases. This suggests that some cases of retained fibrin sheaths may remain undetected or misinterpreted. This is important in patients with known pro-thrombotic and pro-calcification risk factors and prolonged catheter dwell time. Therefore, implementation of preventive strategies, familiarity with radiological findings of this phenomenon, comparison with previous imaging studies, and an overall comprehensive assessment with clinical data is imperative.

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Section: Introductionmentioning

confidence: 99%

Presence of retained calcified fibrin sheath after central venous catheter removal: A systematic literature review

Matusik¹,

Łoboda²,

Kościelska‐Kasprzak

et al. 2020

J Vasc Access

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“…Lu et al also described a calcified fibrin sheath revealed by TEE or CT that was masquerading a retained catheter (15).…”

Section: Stuck Catheter: Removal Techniquesmentioning

confidence: 99%

Dealing with stuck hemodialysis catheter: state of the art and tips for the nephrologist

et al. 2014

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The term stuck catheter refers to the condition in which a catheter is not removable from a central vein using standard techniques. Although it is a rare complication, in the last few years it has been reported ever more frequently in hemodialysis due to the widespread use of tunneled catheters. Poor knowledge of the correct procedures and limited experience and training of the specialist in facing this problem are the main reasons for catheter internalization. Stuck catheter is often diagnosed by the nephrologist who should be competent enough to manage this clinical complication. Among the many options for removing a stuck catheter from the fibrin sleeve, an interventional radiology approach, mainly with endoluminal balloon dilatation, probably provides the best solution. Vascular surgery should be reserved to selected cases in which percutaneous techniques have failed. Nephrologists must play a central role in organizing the treatment of this complication with other specialists in order to avoid making mistakes that may preclude future positive results.

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“…There is little published on calcification of drainage tracts. 1 Increased awareness of this phenomenon may lead to decreased surgical intervention for mistaken foreign bodies.…”

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confidence: 99%