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Calcified Catheter-Related Fibrin Sheath Forms Large Intravenous Cast in Hemodialysis Patient Causing Embolic

Justin Newman1, Ali Syed2, Chava Blivaiss3

  • 1Medical Student, New York Institute of Technology (NYIT) College of Osteopathic Medicine, Glen Head, USA.

Cureus
|December 26, 2022
PubMed

Insights

A rare complication of central venous catheters (CVC) involves calcified fibrin sheaths forming a cast within the vein after catheter removal. This case highlights embolic risks associated with these retained venous casts.

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Radiology

Background:

  • Chronic indwelling central venous catheters (CVCs) are essential for dialysis but can lead to complications.
  • Catheter-related sheath (CRS) formation is a known complication, which can calcify over time.
  • Calcified CRS can rarely persist as an intraluminal cast after CVC removal.

Observation:

  • A 57-year-old dialysis-dependent woman presented with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia.
  • During evaluation, a calcified catheter-shaped cast was identified in her right internal jugular vein.
  • This venous cast was discovered after the removal of her CVC.

Findings:

  • The case details the clinical course, diagnostic imaging, and identification of a retained intraluminal venous cast.
  • Embolic complications were suspected as a sequela of this rare venous cast.
  • The report emphasizes the unique pathology and its potential sequelae.

Implications:

  • This case underscores the importance of recognizing retained venous casts after CVC removal.
  • Understanding the diagnostic and imaging features is crucial for appropriate patient management.
  • Awareness of potential embolic complications associated with these casts is vital for clinicians.

Keywords:
calcificationcatheter related sheathcatheter-tip positiongeneral nephrology dialysis and transplantationmethicillin resistant staphylococcus aureus (mrsa)right atrium

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