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Intravascular linear thrombus after catheter removal: sonographic appearance mimicking retained catheter fragment

Osnat Konen1, Alan Daneman, Jeffrey Traubici

  • 1Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada. konen@zahav.net.il

Pediatric Radiology
|November 8, 2003
PubMed

Insights

Vascular thrombosis after central catheter removal can mimic a retained catheter on ultrasound. Differentiating between thrombus and catheter fragments is crucial to avoid unnecessary invasive procedures.

Area of Science:

  • Pediatric Radiology
  • Vascular Ultrasound
  • Medical Imaging

Background:

  • Central venous and arterial catheters are essential in neonatal care.
  • Vascular thrombosis is a common complication associated with central catheter use.
  • Sonographic imaging can sometimes misinterpret residual thrombus as a retained catheter fragment.

Purpose of the Study:

  • To differentiate the sonographic appearance of intravascular linear thrombus from retained catheter fragments.
  • To improve diagnostic accuracy in cases of suspected catheter retention.

Main Methods:

  • Retrospective analysis of 11 infants who underwent sonography after central catheter removal.
  • Focus on cases where residual thrombus mimicked a retained catheter.
  • Comparison of sonographic features between thrombus and actual catheter fragments.

Main Results:

  • Residual thrombus appeared as two parallel hyperechoic lines.
  • These lines were less sharply defined, less geometrically parallel, and less echogenic than true catheter fragments.
  • Thrombus lacked shadowing and reverberation artifacts seen with retained catheters.

Conclusions:

  • Subtle sonographic differences exist between linear thrombus and retained catheter fragments.
  • Recognizing these differences can prevent misdiagnosis.
  • Accurate sonographic differentiation can obviate the need for more invasive diagnostic procedures.
Abstract

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