Calcified catheter “cast” masquerading as a retained catheter fragment after removal of an implanted venous access device

Sabbaghian, M. Shirin; Rivera, Rafael; Ginsburg, Howard B.; Nadler, Evan P.

doi:10.1007/s00383-007-1911-0

Cited by 12 publications

(10 citation statements)

References 20 publications

(30 reference statements)

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“…2 The phenomenon is explained as part of a foreign-body reaction in which fibronectin is initially deposited around the catheter; 3 later, collagen and cellular activation (with calcium deposition) modify the composition of the sleeve; extensive analysis of the formation led to the term “fibroblastic sheath” being abandoned for the current one. 3 When the sleeve is calcified it appears as a “cast,” as it has been described by several works, 4–6 and it is easy to misinterpret it as a catheter fragment.…”

Section: Resultsmentioning

confidence: 93%

If it looks like a catheter and winds like a catheter . . . fibroblastic sheath mimicking a central venous catheter fragment: A case report

et al. 2019

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Introduction: Fibroblastic sheath formation is a well-known complication of long-term central venous catheters. When calcified, fibroblastic (formerly known as “fibrin”) sheaths may be easily mistaken for retained catheter fragments. We describe one such case and how imaging was used to recognize the sheath and avoid unnecessary interventions. Case Description: A patient with systemic sclerosis was referred for port removal because of suspected infection. A later computed tomography scan showed a persistent tubular structure coursing behind the right clavicle, which was also seen in an anteroposterior chest radiograph. Three-dimensional reconstruction and analysis of the structure’s lumen in comparison to previous imaging studies allowed us to confirm that it was, in fact, a calcified fibroblastic sheath. The patient’s course was uneventful thereafter. Conclusion: Three-dimensional computed tomography reconstruction, as well as the hollow appearance of a tubular structure after removal of a central catheter may help differentiate a fibroblastic sheath from a retained catheter fragment. Accurate surgical notes mentioning the length of the catheter at implant and explant are also of paramount importance.

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Section: Resultsmentioning

confidence: 93%

If it looks like a catheter and winds like a catheter . . . fibroblastic sheath mimicking a central venous catheter fragment: A case report

et al. 2019

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“…Some studies suggest a correlation between the location, duration of catheter use and type of infusions administered 2,8 . The calcified “cast” of CVC has been reported four times in the literature 3,4,7,9 . Two of these cases involved infants with CVC used for TPN 3,8 .…”

Section: Discussionmentioning

confidence: 99%

“…In a case published by Sabbaghian et al ., the diagnosis of calcified “cast” was made 2 weeks after CVC removal. The possibilities of a retained catheter fragment or calcified thrombus were excluded on venogram prior to surgical intervention 4 …”

Section: Discussionmentioning

confidence: 99%

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Calcified catheter “cast” in child after treatment for acute lymphoblastic leukemia

Muszyńska-Rosłan¹,

Panasiuk

Krawczuk‐Rybak

2011

Pediatrics International

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“…Intravenous calcifications after removal of indwelling central venous catheters or implantable venous devices are rare, with few reports in the literature [1,2]. The use of conventional computed tomography (CT) does not necessarily make it easier to differentiate between the presence of a foreign body (tip of a catheter) or intravascular calcifications.…”

Section: Introductionmentioning

confidence: 99%

Densities in the left innominate vein after removal of an implantable venous device: a case report

et al. 2012

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IntroductionPericatheter calcifications are unusual and rare after removal of indwelling central venous catheters with few reports in the literature. We present a case of a woman with calcifications in her left innominate vein after removal of an implantable venous device.Case presentationA venous access port was surgically placed for intravenous chemotherapy in a 19-year-old Caucasian woman who had been diagnosed with acute lymphoblastic leukemia. She developed a fever three and a half years after placement, and the venous access port was removed as it was seen as the only focus for her fever. In the year following its removal, a computed tomography scan was ordered due to a clinical suspicion of deep venous thrombosis of her left arm. The computed tomography scan revealed a hyperdense structure in the left innominate vein with thrombosis. It was concluded that this was a foreign body, a retained catheter fragment after removal of the catheter. After three-dimensional reconstructions were performed, it was determined that these hyperdense structures were calcifications in the left innominate vein that resembled a foreign body.ConclusionsDifferentiating between intravenous thrombotic calcification and a retained catheter tip after removal can be challenging, even with modern day diagnostic tools. Care should be taken to document the length of the catheter upon placement and upon removal. In this manner, unnecessary surgical exploration can be avoided. We would like to highlight the importance of these diagnostic considerations for radiologists and oncologists.

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Calcified catheter “cast” masquerading as a retained catheter fragment after removal of an implanted venous access device

Cited by 12 publications

References 20 publications

If it looks like a catheter and winds like a catheter . . . fibroblastic sheath mimicking a central venous catheter fragment: A case report

If it looks like a catheter and winds like a catheter . . . fibroblastic sheath mimicking a central venous catheter fragment: A case report

Calcified catheter “cast” in child after treatment for acute lymphoblastic leukemia

Densities in the left innominate vein after removal of an implantable venous device: a case report

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