Skip to main content

Advertisement

SpringerLink
Log in

A Novel Technique Using a Protection Filter During Fibrin Sheath Removal for Implanted Venous Access Device Dysfunction

  • Case Report
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

With the increased use of implanted venous access devices (IVADs) for continuous long-term venous access, several techniques such as percutaneous endovascular fibrin sheath removal, have been described, to maintain catheter function. Most standard techniques do not capture the stripped fibrin sheath, which is subsequently released in the pulmonary circulation and may lead to symptomatic pulmonary embolism. The presented case describes an endovascular technique which includes stripping, capture, and removal of fibrin sheath using a novel filter device. A 64-year-old woman presented with IVAD dysfunction. Stripping was performed using a co-axial snare to the filter to capture the fibrin sheath. The captured fragment was subsequently removed for visual and pathological verification. No immediate complication was observed and the patient was discharged the day of the procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Breault S, Glauser F, Babaker M, Doenz F, Qanadli SD. Percutaneous endovascular salvage techniques for implanted venous access device dysfunction. Cardiovasc Interv Radiol. 2015;38:642–50.

    Article  Google Scholar 

  2. Gray RJ, Levitin A, Buck D, et al. Percutaneous fibrin sheath stripping versus transcatheter urokinase infusion for malfunctioning well-positioned tunneled central venous dialysis catheters: a prospective, randomized trial. J Vasc Interv Radiol. 2000;11:1121–9.

    Article  CAS  PubMed  Google Scholar 

  3. Reddy AS, Lang EV, Cutts J, Loh S, Rosen MP. Fibrin sheath removal from central venous catheters: an internal snare manoeuvre. Nephrol Dial Transplant. 2007;22:1762–5.

    Article  PubMed  Google Scholar 

  4. Heye S, Maleux G, Goossens GA, Vaninbroukx J, Jerome M, Stas M. Feasibility and safety of endovascular stripping of totally implantable venous access devices. Cardiovasc Intervent Radiol. 2012;35:607–12.

    Article  PubMed  Google Scholar 

  5. Brismar B, Hardstedt C, Jacobson S. Diagnosis of thrombosis by catheter phlebography after prolonged central venous catheterization. Ann Surg. 1981;194:779–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Tang S, Beigel R, Arsanjani R, Larson B, Luthringer D, Siegel R. Infective endovascular fibrin sheath vegetations—a new cause of bacteremia detected by transesophageal echocardiogram. Am J Med. 2015;128:1029–38.

    Article  PubMed  Google Scholar 

  7. Winn MP, McDermott VG, Schwab SJ, Conlon PJ. Dialysis catheter ‘fibrin-sheath stripping’: a cautionary tale! Nephrol Dial Transplant. 1997;12:1048–50.

    Article  CAS  PubMed  Google Scholar 

  8. Rockoff MA, Gang DL, Vacanti JP. Fatal pulmonary embolism following removal of a central venous catheter. J Pediatr Surg. 1984;19:307–9.

    Article  CAS  PubMed  Google Scholar 

  9. Sinno MC, Alam M. Echocardiographically detected fibrinous sheaths associated with central venous catheters. Echocardiography. 2012;29:E56–9.

    Article  PubMed  Google Scholar 

  10. Johnstone RD, Stewart GA, Akoh JA, Fleet M, Akyol M, Moss JG. Percutaneous fibrin sleeve stripping of failing haemodialysis catheters. Nephrol Dial Transplant. 1999;14:688–91.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cardiothoracic and Vascular Unit, Department of Radiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Charalampos Sotiriadis, Steven David Hajdu, Heloise Barras & Salah Dine Qanadli

  2. Department of Cardiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Sophie Degrauwe

Authors
  1. Charalampos Sotiriadis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven David Hajdu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sophie Degrauwe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Heloise Barras
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Salah Dine Qanadli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Salah Dine Qanadli.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

For this type of study formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sotiriadis, C., Hajdu, S.D., Degrauwe, S. et al. A Novel Technique Using a Protection Filter During Fibrin Sheath Removal for Implanted Venous Access Device Dysfunction. Cardiovasc Intervent Radiol 39, 1209–1212 (2016). https://doi.org/10.1007/s00270-016-1329-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-016-1329-y

Keywords

Search

Navigation