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Embolized fibrin sheath material presenting as intraluminal calcifications within the pulmonary arteries on CT

Mihir Patel1, Pierre D Maldjian1

  • 1Department of Radiology, New Jersey Medical School, Newark, New Jersey, United States.

Journal of Clinical Imaging Science
|September 21, 2022
PubMed

Insights

Fibrin sheath formation can occur around medical devices like automatic implantable cardioverter-defibrillator (AICD) leads. This can lead to pulmonary artery calcifications, a finding radiologists should investigate further.

Area of Science:

  • Vascular Medicine
  • Radiology
  • Medical Device Complications

Background:

  • Fibrin sheath formation is a known complication of indwelling central venous catheters.
  • Fibrin sheaths can also form around other intravascular foreign bodies.
  • Literature on non-catheter-related fibrin sheaths is limited.

Observation:

  • A case of fibrin sheath formation around automatic implantable cardioverter-defibrillator (AICD) leads in the left brachiocephalic vein is presented.
  • Embolization of fibrin sheath material resulted in pulmonary vasculature calcifications.
  • Computed tomography (CT) revealed these intraluminal calcifications.

Findings:

  • The study highlights a rare cause of pulmonary artery calcifications.
  • Fibrin sheath embolization from AICD leads is identified as the source.
  • Radiological findings include calcifications within the pulmonary arteries.

Implications:

  • Radiologists should consider fibrin sheath embolization as a differential diagnosis for pulmonary artery calcifications.
  • Identifying the source requires searching for fibrin sheath remnants in the central venous system.
  • This finding expands the understanding of foreign body-related venous complications.

Keywords:
CT pulmonary arteriesFibrin sheathFibrin sheath embolizationIntraluminal calcificationsPulmonary artery calcifications

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