Abstract No. 185 Impact of anticoagulation and antiplatelet therapy on dialysis catheter fibrin sheath formation

Peripherally inserted central catheter line entrapment is a rare complication in the neonatal intensive care unit and only a small number of cases have been reported. While studies have suggested recommendations for removal, there is still a need for surgical intervention in some cases. This is a case of a premature infant with long term peripherally inserted central catheter line placement with fibrin sheath formation that required multiple attempts before successful noninvasive removal and a review of the cases with difficult peripherally inserted central catheter removal in newborns.

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Technical benefits and outcomes of modified upwardly created subcutaneous chest pockets for placing central venous ports: Single-center experience

Acta Radiologica ◽

10.1080/02841850902783320 ◽

2009 ◽

Vol 50 (4) ◽

pp. 368-373 ◽

Cited By ~ 1

Author(s):

Sang Hoon Lee ◽

Ho Jong Chun ◽

Byung Gil Choi

Keyword(s):

Infectious Complications ◽

Central Venous ◽

Technical Success Rate ◽

Mechanical Complications ◽

Single Center Experience ◽

Modified Method ◽

Fibrin Sheath ◽

Catheter Malfunction ◽

Sheath Formation ◽

Catheter Fracture

Background: Traditionally, port pockets are created in a surgical fashion, with the chest pocket dissection performed by moving in the caudal direction from the incision site. However, most right-handed operators can more easily make the port pocket by dissecting upward. Purpose: To evaluate the technical benefits and outcomes of modified upwardly created subcutaneous chest pockets to allow for placement of central venous ports. Material and Methods: We retrospectively reviewed the clinical and radiological records of 756 insertion procedures in 750 patients who were referred for image-guided implantation of chest ports. Of the 121 removal procedures reviewed, a modified chest pocket was created in 104 of them. The technical benefits and outcomes of the modified procedures were evaluated. Results: The technical success rate of the modified method was 99% for implantation and 100% for removal procedures. No patients had major immediate complications related to the procedure. Early mechanical complications were observed in two patients: one was due to a port that turned over following implantation, and the other was due to separation of the catheter and hub-port. Late mechanical complications were observed in six patients: catheter malfunction occurred in three patients due to fibrin sheath formation, and three patients experienced catheter fracture. The rate of early and late infectious complications was 0.10 and 0.09 per 100 catheter days, respectively. There were five patients with symptomatic central venous thrombosis (range 34–167 days). Conclusion: Modified upwardly created chest pockets are useful for implantable central venous port systems, and may be easier to implant and remove than conventional downward pocket methods.

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Tunneled Dialysis Catheter Exchange with Fibrin Sheath Disruption is not Associated with Increased Rate of Bacteremia

The Journal of Vascular Access ◽

10.5301/jva.5000301 ◽

2014 ◽

Vol 16 (1) ◽

pp. 52-56 ◽

Cited By ~ 7

Author(s):

Amanda M. Valliant ◽

Muhammad K. Chaudhry ◽

Alexanders Yevzlin ◽

Brad Astor ◽

Micah R. Chan

Keyword(s):

Dialysis Catheter ◽

Catheter Exchange ◽

Fibrin Sheath

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Endovascular Snaring Technique for Shortening of Central Venous Port Catheters in Children

10.1093/med/9780199986071.003.0042 ◽

2018 ◽

Author(s):

Mahmoud Zahra ◽

Ganesh Krishnamurthy

Keyword(s):

Superior Vena ◽

Vena Cava ◽

Central Venous ◽

Central Venous Port ◽

Catheter Occlusion ◽

Venous Port ◽

Fibrin Sheath ◽

Term Delivery ◽

Catheter Tip ◽

Sheath Formation

Implanted venous ports in children are commonly placed by pediatric interventional radiologists, primarily through the internal jugular vein to allow long-term delivery of intravenous access. The ideal location of the catheter tip is the junction of the superior vena cava and right atrium. High catheter tip positions may result in failure of the port catheter due to venous thrombosis, catheter occlusion, or fibrin sheath formation, whereas low catheter tip positions may cause catheter occlusion, cardiac arrhythmias, or perforation. This chapter describes indications, contraindications, equipment, techniques, and complications of the endovascular snaring technique of central venous port tip revision in children.

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