Fluoroscopy of central venous catheters

Author: Mikael Häggström

The fibrin sheath is indirectly seen in these images before and after radiocontrast infusion, as the radiocontrast collects around the catheter.

Fibrin sheaths of central venous catheters can be suspected when it is possible to infuse into it but not to aspirate.

Technique

Fibrin sheaths are usually detected by fluoroscopic catheter contrast angiography. Non-ionic contrastwith a high iodine concentration (for example 300 mg/ml) is injected by hand using a 20-ml syringe. A precontrast view is followed by a series of images with at 2–4 images/s and small field-of-view.