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.”
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kenney BD, David M, Bensoussan AL (1996) Anticoagulation without catheter removal in children with catheter-related central vein thrombosis. J Pediatr Surg 31:816–818
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 6:623–627
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 52:616–620
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 149:671–675
Cardella J, Lukens M, Fox P (1994) Fibrin sheath entrapment of peripherally inserted central catheters. J Vase Interv Radiol 5:439–442
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 7:513–517
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 198:41–44
Crain MR, Horton MG, Mewissen MW (1998) Fibrin sheaths complicating central venous catheters. AJR 171:341–346
Twardowski ZJ (1998) High-dose intradialytic urokinase to restore the patency of permanent central vein hemodialysis catheters. Am J Kidney Dis 31:841–847
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 684–693
Forbes CD, Courtney FM (1987) Thrombosis and artificial surfaces. In: Bloom AL, Thomas DP (eds) Haemostasis and Thrombosis, 2nd edn. Churchill Livingstone, Edinburgh, pp 902–921
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Suojanen, J.N., Brophy, D.P. & Nasser, I. Thrombus on indwelling central venous catheters: The histopathology of “fibrin sheaths”. Cardiovasc Intervent Radiol 23, 194–197 (2000). https://doi.org/10.1007/s002700010042
Issue Date:
DOI: https://doi.org/10.1007/s002700010042