Incidence of ultrasound‐detected asymptomatic long‐term central vein catheter‐related thrombosis and fibrin sheath in cancer patients

Abstract

Asymptomatic DVT and fibrin sheaths do not represent per se an indication for removal of functioning CVC in cancer patients who need central vein access.

Right atrial catheter “ghost” removal by cardiac surgery: A pediatric case series report

“…Medical therapy is effective only in the early days after catheter implantation . In cases of calcified fibrin sheath, which represent 45% of residual fibrin sheaths, anticoagulation therapy seems to be useless . Resection under cardiopulmonary bypass has previously been described in cases of infected fibrin sheath embolization in the right atrium and when medical therapy has failed …”

“…In case of medical therapy failure, close follow‐up is especially needed. Risk factors for fibrin sheath emergence have been previously studied . Small vein area and low platelet count seem to be associated with higher fibrin sheath prevalence .…”

“…Risk factors for fibrin sheath emergence have been previously studied . Small vein area and low platelet count seem to be associated with higher fibrin sheath prevalence . All our fibrin sheath cases occurred with polyurethane catheters.…”

“…Silicone seems to be associated with more fibrin sheath infectious and thrombotic catheter occlusion than polyurethane catheter . As catheter composition may influence the risk of residual fibrin sheath, newly engineered micropattern imprinted on catheters are in development . Despite the fact that catheter dwell time did not reach statistical significance in previous studies, recommendations are made to leave the catheter in place for the shortest time possible …”

Reconsidering the GAVeCeLT Consensus on catheter-related thrombosis, 13 years later

“…Even if mechanisms of fibroblastic sleeve and thrombosis formation are well-known, their relationship remains still unclear. 21 16 US guidance is nowadays considered a standard of care for catheter insertion and appropriate vein choice. 22 Since 2008, an extensive body of evidence has demonstrated that real-time ultrasound-guided venipuncture reduces the risk of CRT.…”