Thrombus on indwelling central venous catheters: The histopathology of “fibrin sheaths”
Clinical Investigations
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Abstract
Purpose: Central venous catheters (CVC) may fail for many reasons, though “fibrin sheaths” blocking catheter ports are usually implicated. We examined the sheaths removed from dialysis catheters to determine their histopathology.
Methods: Ten catheter strippings were performed and the removed material was studied grossly and microscopically.
Results: The histologic specimens showed thrombus both with and without a proteinaceous sheath.
Conclusion: Dialysis catheters fail because of thrombus formation. This can occur in either the absence or presence of a protein coating on the catheter, the so-called “fibrin sheath.”
Key words
Catheters and catheterization Central venous access Complications Catheters, indwelling Hemodialysis Dialysis, shuntsPreview
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References
- 1.Kenney BD, David M, Bensoussan AL (1996) Anticoagulation without catheter removal in children with catheter-related central vein thrombosis. J Pediatr Surg 31:816–818PubMedCrossRefGoogle Scholar
- 2.Knelson M, Hudson E, Suhocki P, Payne C, Sallee D, Newman G (1995) Functional restoration of occluded central venous catheters: New interventional techniques. J Vase Interv Radiol 6:623–627CrossRefGoogle Scholar
- 3.Rockall A, Harris C, Wetton CWN, Taube D, Gedroyc W, Al-Kutoubi MA (1997) Stripping of failing haemodialysis catheters using the Ampltaz gooseneck snare. Clin Radiol 52:616–620PubMedCrossRefGoogle Scholar
- 4.Cassidy F, Zajko A, Bron K, Reilly J, Peitzman A, Steed D (1987) Noninfectious complications of long-term central venous catheters: Radiologic evaluation and management. AJR 149:671–675PubMedGoogle Scholar
- 5.Cardella J, Lukens M, Fox P (1994) Fibrin sheath entrapment of peripherally inserted central catheters. J Vase Interv Radiol 5:439–442CrossRefGoogle Scholar
- 6.Haskal ZJ, Leen VH, Thomas-Hawkins C, Shlansky-Goldberg RD, Baum RA, Soulen MC (1996) Transvenous removal of fibrin sheaths from tunneled hemodialysis catheters. J Vase Interv Radiol 7:513–517CrossRefGoogle Scholar
- 7.Crain MR, Mewissen MW, Ostrowski GJ, Paz-Fumagalli R, Beres RA, Wertz RA (1996) Fibrin sleeve stripping for salvage of failing hemodialysis catheters: Technique and initial results. Radiology 198:41–44PubMedGoogle Scholar
- 8.Crain MR, Horton MG, Mewissen MW (1998) Fibrin sheaths complicating central venous catheters. AJR 171:341–346PubMedGoogle Scholar
- 9.Twardowski ZJ (1998) High-dose intradialytic urokinase to restore the patency of permanent central vein hemodialysis catheters. Am J Kidney Dis 31:841–847PubMedCrossRefGoogle Scholar
- 10.Greenberg CS, Orthner CL (1998) Blood coagulation and fibrinolysis. In: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM (eds) Wintrobe’s Clinical Hematology, 10th edn. Williams & Wilkins, Baltimore, pp 684–693Google Scholar
- 11.Forbes CD, Courtney FM (1987) Thrombosis and artificial surfaces. In: Bloom AL, Thomas DP (eds) Haemostasis and Thrombosis, 2nd edn. Churchill Livingstone, Edinburgh, pp 902–921Google Scholar
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