Fibrin sheaths and central venous catheter occlusions: diagnosis and management

Central venous catheter malfunction diagnosis and treatment is a growing component of the field of interventional radiology. A thorough understanding of the causes of catheter malfunction and the technical skills needed to treat these problems are necessities to appropriate management. In long-standing central venous catheters, the formation of a fibrin sheath can and often does contribute to catheter malfunction. Differentiating a sheath from thrombus is imperative to appropriate therapy. The purpose of this article is to provide an understanding of the causes of fibrin sheaths and how to treat them.