Retained fibrin sheaths: Chest computed tomography findings and clinical associations

David J. Krausz, Jessica S. Fisher, Galia Rosen, Linda B. Haramati, Vineet R. Jain, William B. Burton, Alla Godelman, Jeffrey M. Levsky, Benjamin H. Taragin, Jacob Cynamon, Galit Aviram

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

PURPOSE:: Fibrin sheaths may develop around long-term indwelling central venous catheters (CVCs) and remain in place after the catheters are removed. We evaluated the prevalence, computed tomographic (CT) appearance, and clinical associations of retained fibrin sheaths after CVC removal. MATERIALS AND METHODS:: We retrospectively identified 147 adults (77 men and 70 women; mean age 58 y) who underwent CT after CVC removal. The prevalence of fibrin sheath remnants was calculated. Bivariate and multivariate analyses were performed to assess for associations between sheath remnants and underlying diagnoses leading to CVC placement; patients' age and sex; venous stenosis, occlusion, and collaterals; CVC infection; and pulmonary embolism. RESULTS:: Retained fibrin sheaths were present in 13.6% (20/147) of cases, of which 45% (9/20) were calcified. Bivariate analysis revealed sheath remnants to be more common in women than in men [23% (16/70) vs. 5% (4/77), P=0.0018] and to be more commonly associated with venous occlusion and collaterals [30% (6/20) vs. 5% (6/127), P=0.0001 and 30% (6/20) vs. 6% (7/127), P=0.000s3, respectively]. Other variables were not associated. Multivariate analysis confirmed the relationship between fibrin sheaths and both female sex (P=0.005) and venous occlusion (P=0.01). CONCLUSIONS:: Retained fibrin sheaths were seen on CT in a substantial minority of patients after CVC removal; nearly half of them were calcified. They were more common in women and associated with venous occlusion.

Original languageEnglish (US)
Pages (from-to)118-124
Number of pages7
JournalJournal of Thoracic Imaging
Volume29
Issue number2
DOIs
StatePublished - Mar 2014

Fingerprint

Central Venous Catheters
Fibrin
Thorax
Tomography
Multivariate Analysis
Indwelling Catheters
Pulmonary Embolism
Pathologic Constriction
Catheters
Infection

Keywords

  • catheters
  • computed tomography
  • veins

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pulmonary and Respiratory Medicine

Cite this

Retained fibrin sheaths : Chest computed tomography findings and clinical associations. / Krausz, David J.; Fisher, Jessica S.; Rosen, Galia; Haramati, Linda B.; Jain, Vineet R.; Burton, William B.; Godelman, Alla; Levsky, Jeffrey M.; Taragin, Benjamin H.; Cynamon, Jacob; Aviram, Galit.

In: Journal of Thoracic Imaging, Vol. 29, No. 2, 03.2014, p. 118-124.

Research output: Contribution to journalArticle

Krausz, David J. ; Fisher, Jessica S. ; Rosen, Galia ; Haramati, Linda B. ; Jain, Vineet R. ; Burton, William B. ; Godelman, Alla ; Levsky, Jeffrey M. ; Taragin, Benjamin H. ; Cynamon, Jacob ; Aviram, Galit. / Retained fibrin sheaths : Chest computed tomography findings and clinical associations. In: Journal of Thoracic Imaging. 2014 ; Vol. 29, No. 2. pp. 118-124.
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abstract = "PURPOSE:: Fibrin sheaths may develop around long-term indwelling central venous catheters (CVCs) and remain in place after the catheters are removed. We evaluated the prevalence, computed tomographic (CT) appearance, and clinical associations of retained fibrin sheaths after CVC removal. MATERIALS AND METHODS:: We retrospectively identified 147 adults (77 men and 70 women; mean age 58 y) who underwent CT after CVC removal. The prevalence of fibrin sheath remnants was calculated. Bivariate and multivariate analyses were performed to assess for associations between sheath remnants and underlying diagnoses leading to CVC placement; patients' age and sex; venous stenosis, occlusion, and collaterals; CVC infection; and pulmonary embolism. RESULTS:: Retained fibrin sheaths were present in 13.6{\%} (20/147) of cases, of which 45{\%} (9/20) were calcified. Bivariate analysis revealed sheath remnants to be more common in women than in men [23{\%} (16/70) vs. 5{\%} (4/77), P=0.0018] and to be more commonly associated with venous occlusion and collaterals [30{\%} (6/20) vs. 5{\%} (6/127), P=0.0001 and 30{\%} (6/20) vs. 6{\%} (7/127), P=0.000s3, respectively]. Other variables were not associated. Multivariate analysis confirmed the relationship between fibrin sheaths and both female sex (P=0.005) and venous occlusion (P=0.01). CONCLUSIONS:: Retained fibrin sheaths were seen on CT in a substantial minority of patients after CVC removal; nearly half of them were calcified. They were more common in women and associated with venous occlusion.",
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T1 - Retained fibrin sheaths

T2 - Chest computed tomography findings and clinical associations

AU - Krausz, David J.

AU - Fisher, Jessica S.

AU - Rosen, Galia

AU - Haramati, Linda B.

AU - Jain, Vineet R.

AU - Burton, William B.

AU - Godelman, Alla

AU - Levsky, Jeffrey M.

AU - Taragin, Benjamin H.

AU - Cynamon, Jacob

AU - Aviram, Galit

PY - 2014/3

Y1 - 2014/3

N2 - PURPOSE:: Fibrin sheaths may develop around long-term indwelling central venous catheters (CVCs) and remain in place after the catheters are removed. We evaluated the prevalence, computed tomographic (CT) appearance, and clinical associations of retained fibrin sheaths after CVC removal. MATERIALS AND METHODS:: We retrospectively identified 147 adults (77 men and 70 women; mean age 58 y) who underwent CT after CVC removal. The prevalence of fibrin sheath remnants was calculated. Bivariate and multivariate analyses were performed to assess for associations between sheath remnants and underlying diagnoses leading to CVC placement; patients' age and sex; venous stenosis, occlusion, and collaterals; CVC infection; and pulmonary embolism. RESULTS:: Retained fibrin sheaths were present in 13.6% (20/147) of cases, of which 45% (9/20) were calcified. Bivariate analysis revealed sheath remnants to be more common in women than in men [23% (16/70) vs. 5% (4/77), P=0.0018] and to be more commonly associated with venous occlusion and collaterals [30% (6/20) vs. 5% (6/127), P=0.0001 and 30% (6/20) vs. 6% (7/127), P=0.000s3, respectively]. Other variables were not associated. Multivariate analysis confirmed the relationship between fibrin sheaths and both female sex (P=0.005) and venous occlusion (P=0.01). CONCLUSIONS:: Retained fibrin sheaths were seen on CT in a substantial minority of patients after CVC removal; nearly half of them were calcified. They were more common in women and associated with venous occlusion.

AB - PURPOSE:: Fibrin sheaths may develop around long-term indwelling central venous catheters (CVCs) and remain in place after the catheters are removed. We evaluated the prevalence, computed tomographic (CT) appearance, and clinical associations of retained fibrin sheaths after CVC removal. MATERIALS AND METHODS:: We retrospectively identified 147 adults (77 men and 70 women; mean age 58 y) who underwent CT after CVC removal. The prevalence of fibrin sheath remnants was calculated. Bivariate and multivariate analyses were performed to assess for associations between sheath remnants and underlying diagnoses leading to CVC placement; patients' age and sex; venous stenosis, occlusion, and collaterals; CVC infection; and pulmonary embolism. RESULTS:: Retained fibrin sheaths were present in 13.6% (20/147) of cases, of which 45% (9/20) were calcified. Bivariate analysis revealed sheath remnants to be more common in women than in men [23% (16/70) vs. 5% (4/77), P=0.0018] and to be more commonly associated with venous occlusion and collaterals [30% (6/20) vs. 5% (6/127), P=0.0001 and 30% (6/20) vs. 6% (7/127), P=0.000s3, respectively]. Other variables were not associated. Multivariate analysis confirmed the relationship between fibrin sheaths and both female sex (P=0.005) and venous occlusion (P=0.01). CONCLUSIONS:: Retained fibrin sheaths were seen on CT in a substantial minority of patients after CVC removal; nearly half of them were calcified. They were more common in women and associated with venous occlusion.

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KW - computed tomography

KW - veins

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