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Published on: November 28, 2018
Retained fibrin sleeve: transesophageal echocardiographic observations
Priscilla J Peters1, Jina Sohn, Michael Butler
1Division of Cardiology, Cooper University Hospital, Camden, NJ 08103, USA. peters-priscilla@cooperhealth.edu
Insights
This study highlights the echocardiographic features of retained fibrin sheaths, a common complication after central venous catheter removal. These findings aid in understanding and diagnosing this condition in patients with complex medical histories.
Area of Science:
- Cardiology
- Medical Imaging
- Vascular Surgery
Background:
- Echocardiography is crucial for assessing thrombus on intracardiac catheters.
- Retained fibrin sheaths, a fibrin sleeve adhering to the vessel wall post-catheter removal, are less understood.
- These sheaths can complicate venous access sites.
Observation:
- The study presents transesophageal echocardiographic findings of a retained fibrin sheath.
- The patient had end-stage renal disease and infective endocarditis of the aortic valve.
- The sheath was observed adhering to the vessel wall after catheter removal.
Findings:
- Transesophageal echocardiography visualized the retained fibrin sheath.
- The fibrin sheath was characterized by its echogenicity and adherence to the vessel wall.
- This imaging modality can identify fibrin sheaths even after catheter removal.
Implications:
- Understanding echocardiographic characteristics of fibrin sheaths improves diagnosis.
- This knowledge is vital for managing patients with indwelling catheters, especially those with comorbidities.
- Further research can refine imaging protocols for retained fibrin sheaths.
Abstract:
The role of echocardiography for the evaluation of thrombus formation on indwelling intracardiac catheters is well established. Considerably less well described, however, are the echocardiographic characteristics of the so-called retained fibrin sheath, a sleeve of fibrin that surrounds the catheter at the point at which it enters the vein that commonly remains adherent to the vessel wall after catheter removal. The authors report the transesophageal echocardiographic findings of a retained fibrin sheath following catheter removal in a patient with end-stage renal disease and infective endocarditis of the aortic valve.
