fibrin and Foreign-Bodies

The presence of a vascular access device (or of any intravascular foreign body) inside the bloodstream is often associated with the formation of a connective tissue sleeve around the catheter (often named-erroneously-"fibrin sleeve"). Such sleeve is usually a physiological phenomenon with little or no clinical relevance, but its pathogenesis is still unclear, so that it is frequently confused with venous thrombosis; also, its relationship with other major catheter-related complications, such as venous thrombosis and bloodstream infection, is uncertain. This narrative review tries to convey in a systematic form the current knowledge about pathogenesis, incidence, clinical manifestations, diagnosis, and management of this phenomenon.

Topics: Catheterization, Central Venous; Catheters, Indwelling; Fibrin; Foreign Bodies; Humans; Venous Thrombosis

The insertion and management of long-term venous catheters have long been the province of anaesthetists, intensive care physicians and surgeons. Radiologists are taking an increasing role in the insertion of central venous catheters (CVCs) because of their familiarity with the imaging equipment and their ability to manipulate catheters and guide-wires. The radiological management of the complications of CVCs has also expanded as a result. This article reviews the role of radiology in central venous access, covering the detection and management of their complications.

Topics: Aorta; Arteries; Catheterization, Central Venous; Fibrin; Foreign Bodies; Heart Injuries; Humans; Pneumothorax; Practice Guidelines as Topic; Pulmonary Artery; Radiology; Ultrasonography, Interventional; Venous Thrombosis

A foreign body left in left atrium after catheter ablation of atrial fibrillation is a very rare complication. Nevertheless, there are no reports so far about a large newly emerged structure only giving the impression of being a foreign body left in the heart after catheter ablation.. This report presents a case of a patient after catheter ablation for persistent atrial fibrillation. Because of atrial tachycardia during follow-up, patient was indicated for reablation. Imaging methods including intracardiac echocardiography showed a straw-like foreign body with the character of a transseptal sheath in left atrium. A cardiac surgery was performed with extraction of the foreign body. We found a fibrous chord-like material in the left atrium, microscopy showed myocardial tissue with continuous transition to fibrinous elastic vessel. No signs of foreign material were found.. We have found a newly emerged body giving the impression of being of foreign origin in left atrium after catheter ablation of atrial fibrillation. Microscopy of the extracted material showed myocardial tissue with continuous transition to fibrinous elastic vessel and a fibrinous tissue with focal dystrophic calcification. Its origin remains unknown.

Topics: Aged; Atrial Fibrillation; Blood Vessels; Catheter Ablation; Diagnostic Errors; Echocardiography, Transesophageal; Fibrin; Foreign Bodies; Heart Atria; Humans; Magnetic Resonance Imaging; Male; Myocardium; Tomography, X-Ray Computed

The reaction of rat tissues was studied using the methods of light microscopy 4, 12, 18 days, 1, 2, 6 and 12 months after hypodermic implantation of polymeric films made of polyhydroxyalkanoates (PHA). It was found that polymer, like any foreign matter in an organism, become immediately covered by fibrin. By day 4, there the deformation and destruction of polymeric films were observed due to fibrin contraction. Further, the foreign body was covered by a connective tissue capsule. Under the action of myofibroblasts, the capsule around PHA contracted, thus further deforming and breaking the polymer. Small particles of polymer were covered by macrophages, after some time the cytoplasm of macrophages fused forming the giant cells of foreign body type. After the prolonged period, small fragments of polymeric films were almost completely degraded by macrophages. Large polymeric fragments that were not deformed or crushed, became encapsulated by fibrous tissue and remained unchanged for long time periods.

Topics: Animals; Biocompatible Materials; Connective Tissue; Fibrin; Foreign Bodies; Foreign-Body Reaction; Macrophages; Male; Polyhydroxyalkanoates; Polymers; Rats

Various surgical techniques for the removal of a foreign body from maxillary sinuses have been reported. However, the access window in the lateral wall of the maxillary sinus cavity is not replaced by a bony wall when sinus grafting is not performed. The replaceable bony window provides an access window into the sinus cavity and maintains the integrity of the lateral wall of the sinus cavity after the removal of a foreign body from the sinus. Saline irrigation and suction are simple and quick techniques to remove foreign bodies from the sinus. This technique does not require special equipment, including that of endoscopy.

Topics: Adult; Blood Platelets; Dental Implants; Fibrin; Follow-Up Studies; Foreign Bodies; Foreign-Body Migration; Humans; Male; Maxillary Sinus; Mucous Membrane; Osteogenesis; Osteotomy; Sodium Chloride; Suction; Surgical Flaps; Therapeutic Irrigation; Tooth Root

To determine the incidence of pericatheter sleeve formation, thrombus formation, and stenosis of the central veins in hemodialysis patients with temporary catheters.. In this prospective study, 57 patients (40 males, 17 females) with temporary dialysis catheters had catheter venography by pulling back the catheter just before removal. Patient's age range was 25-87 years (mean age, 51 years). The venographic studies were evaluated for pericatheter sleeve formation, thrombus formation, and stenosis of the brachiocephalic vein (BCV) and the superior vena cava (SVC). The IJV could only be evaluated if there was adequate filling during contrast administration. In a subgroup of patients who had had only right IJV or only right SCV catheters, impact of these catheters on the central veins was compared.. The catheter location was right internal jugular vein (IJV) in 26 cases, right subclavian vein (SCV) in 27 cases, left IJV in 1 case, and left SCV in 3 cases. Thirty-two patients (56%) had had only one temporary catheter and the rest had had more than one inserted. The mean dwell time for the catheters was 21 days (range 7-59 days). A pericatheter sleeve was detected on venography in 32 (56%) patients and thrombus formation was noted in 16 patients (28%). A total of 41 patients (72%) exhibited pericatheter sleeve and/or thrombus formation. While 19 of the 32 patients (59%) without previous catheterization had a sleeve around the catheter, only 13 (52%) of 25 patients who had had multiple catheters inserted had a sleeve (P > 0.005). Of the eight patients (14%) with BCV stenosis, two had >50% stenosis. Only one patient (2%) had mild stenosis of the SVC. Three patients out of 15 (20%) who had diagnostic venography for the IJV had severe stenosis of the vein. Pericatheter sleeve formation was more frequent in women (P < 0.005). However, there were no statistical differences with respect to pericatheter sleeve formation, luminal filling defect and BCV stenosis when patients were grouped according to age, dwell time of the catheter, number of catheters inserted, and diameter of the SVC. Forty-two of the fifty-seven patients had had only right IJV (n =16) or right SCV (n = 26) catheters. There were no differences between these groups with respect to rates of pericatheter sleeve formation, thrombus formation, or BCV stenosis.. This study showed that even short-term catheters result in significantly high rates of pericatheter sleeve and thrombus formation which are two of the important causes of catheter malfunction. The IJV route is known to be much safer than the SCV route with respect to stenosis formation in the vein in which the catheter is inserted; however, the result showed no differences between the two routes with respect to frequencies of pericatheter sleeve formation, thrombus formation, and BCV stenosis. These findings remind us again that we should avoid unnecessary catheter insertion even for short-term in these chronically ill patients.

Topics: Adult; Aged; Aged, 80 and over; Brachiocephalic Veins; Catheterization, Central Venous; Catheters, Indwelling; Constriction, Pathologic; Contrast Media; Female; Fibrin; Foreign Bodies; Humans; Jugular Veins; Male; Middle Aged; Phlebography; Prospective Studies; Renal Dialysis; Sex Factors; Subclavian Vein; Time Factors; Vena Cava, Superior; Venous Thrombosis

Mice with homozygous deletion of the plasminogen activator inhibitor-1 gene (PAI-1(-/-)) are relatively protected from bleomycin-induced pulmonary fibrosis. At least part of the protective effect appears to occur during the latter stages of the pathological process when fibrotic tissue is being deposited. To investigate the effect of PAI-1 deficiency on fibrosis, we studied the accumulation of fibrotic tissue within subcutaneously implanted polyvinyl alcohol sponges. Similar to the effect of PAI-1 deficiency on bleomycin-induced pulmonary fibrosis, the accumulation of fibrotic tissue within implanted sponges occurred more slowly in PAI-1(-/-) compared to wild-type mice. Another striking difference observed in the PAI-1(-/-) mice was the rapid removal of a fibrin-rich matrix that formed within the sponges by 1 day after implantation in both wild-type and PAI-1(-/-) mice. The pattern of connective tissue invasion also differed: cells in wild-type mice infiltrated as individually penetrating cells whereas in PAI-1(-/-) mice they did so as a well-demarcated advancing front. Providing an alternative provisional matrix by impregnating sponges with a low concentration of collagen before implantation corrected the changes induced by PAI-1 deficiency. In conclusion, PAI-1 deficiency appears to affect fibrotic tissue formation in part by altering the provisional matrix that forms soon after tissue injury.

Topics: Animals; Collagen; Extracellular Matrix; Fibrin; Fibrosis; Foreign Bodies; Hydroxyproline; Lung; Mice; Mice, Inbred C57BL; Mice, Knockout; Plasminogen Activator Inhibitor 1; Polyvinyl Alcohol; Prostheses and Implants

Rice bodies are free corpuscles of synovial origin with a cartilage-like appearance that may reach hundreds in number in the intra-articular space. Rheumatologic or infectious pathologies that may produce synovial hypertrophy play a major role in the etiology. Already recognized by rheumatologists, this entity is rarely reported in orthopaedic literature. Numerous particles in the size and form of rice bodies were noted in the knee joint of an 11-year-old patient who underwent arthroscopic drainage and partial synovectomy. Histopathologic examination showed that some of the rice bodies consisted only of fibrin and some of them included a collagenous nucleus surrounded by a fibrin layer. No evidence of recurrence was observed by orthopaedic and rheumatologic evaluations within 2.5 years after the arthroscopic procedure.

Topics: Arthroscopy; Child; Collagen; Debridement; Fibrin; Foreign Bodies; Humans; Hypertrophy; Knee Joint; Male; Radiography; Range of Motion, Articular; Synovectomy; Synovial Membrane; Treatment Outcome

Topics: Echocardiography; Female; Fibrin; Foreign Bodies; Humans; Middle Aged; Pericardium

Topics: Female; Fibrin; Foreign Bodies; Gastrostomy; Humans; Intestinal Perforation; Male; Middle Aged; Peritoneal Cavity; Stomach

An intrapleural free floating golf ball size body was an incidental finding at autopsy. The pathogenesis and clinical significance of this lesion are discussed.

Topics: Fibrin; Foreign Bodies; Humans; Male; Middle Aged; Pleura; Pleural Diseases

Topics: Adult; Aged; Autopsy; Collagen; Erythrocytes; Fascia; Fascia Lata; Female; Fibrin; Fibroblasts; Foreign Bodies; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Leukocytes; Macrophages; Male; Middle Aged; Mitral Valve; Transplantation, Autologous; Tricuspid Valve

Topics: Animals; Capillary Permeability; Cell Migration Inhibition; Cell Movement; Connective Tissue; Connective Tissue Cells; Depression, Chemical; Diphenhydramine; Disease Models, Animal; Exudates and Transudates; Fibrin; Fibroblasts; Foreign Bodies; Glycoproteins; Glycosaminoglycans; Histocytochemistry; Inflammation; Male; Mast Cells; Methods; Mucoproteins; Neutrophils; Phagocytosis; Proteins; Rats; RNA; Time Factors

Topics: Adult; Age Factors; Aged; Catheterization; Contrast Media; Female; Fibrin; Foreign Bodies; Humans; Jugular Veins; Male; Methods; Phlebography; Subclavian Vein; Thrombophlebitis

Topics: Animals; Collagen; Connective Tissue; Edema; Fibrin; Fibroblasts; Foreign Bodies; Guinea Pigs; Leukocytes; Macrophages; Polyvinyls; Scurvy; Staining and Labeling

Topics: Acrylic Resins; Animals; Blood Platelets; Dogs; Erythrocytes; Fibrin; Foreign Bodies; Glass; Jugular Veins; Microscopy; Thrombosis