Ultrasonic characteristics of inserted central catheter related fibroblastic sleeve

Abstract This study was aimed to summarize the ultrasonic characteristics of inserted central catheter (ICC) related fibroblastic sleeve, providing theoretical basis for its early diagnosis. Clinical and ultrasonic data of patients with ICC confirmed by pathology to have fibroblastic sleeves in our...

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Main Authors: Zhifei Ben, Jue Wang, Jinyong Zhan, Kaiying Xu
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-88285-w
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author Zhifei Ben
Jue Wang
Jinyong Zhan
Kaiying Xu
author_facet Zhifei Ben
Jue Wang
Jinyong Zhan
Kaiying Xu
author_sort Zhifei Ben
collection DOAJ
description Abstract This study was aimed to summarize the ultrasonic characteristics of inserted central catheter (ICC) related fibroblastic sleeve, providing theoretical basis for its early diagnosis. Clinical and ultrasonic data of patients with ICC confirmed by pathology to have fibroblastic sleeves in our hospital from June 4, 2020 to April 1, 2024 were collected. All ICCs were made of polyurethane. Patients required the ultrasound evaluation due to local swelling and pain, abnormal coagulation function, lack of response to flushing of saline and heparin, or before extubation. The ultrasonic characteristics of fibroblastic sleeve such as its starting point, shape, thickness, internal echo, number of layers, relationship to the catheter, and presence or absence of thrombosis were analyzed. After the removal of the ICC, there was a membrane-like structure adhesion on the surface of the catheter, which was composed of endothelial cells, smooth muscle cells, collagen and fibrous connective tissues. A total of 95 patients with pathologically confirmed fibroblastic sleeve were present, of which 44 patients had only fibroblastic sleeves (46.32%) and 51 patients had fibroblastic sleeves with thrombi (53.68%). The fibroblastic sleeve originated from the site where the catheter contacted the vein wall and extended in a distal direction, with a thickness ranged between 0.7  and 5.6 mm. With the pathological results as the gold standard, the optimal cut-off value for the diagnosis of fibroblastic sleeve with thrombosis was 2.58 mm, and the sensitivity and specificity of the diagnosis were 95.45% and 96.08%. Compared to echogenicity of the catheter wall, hyperechoic or isoechoic fibroblastic sleeves were observed in 89 patients, while hypoechoic fibroblastic sleeves were observed in 6 patients. There were significant differences in the location of catheterization and duration of catheterization between the single-layer group and the double-layer group (P < 0.05). Fibroblastic sleeves were tightly attached to the catheter walls in 78 patients and loosely attached to the catheter walls in 17 patients, with significant differences in the location of catheterization and duration of catheterization (P < 0.05). ICC-related fibroblastic sleeves have specific ultrasonic characteristics. Understanding these ultrasonic characteristics can provide a reliable basis for their early diagnosis and timely treatment.
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spelling doaj-art-cb59a52451664e8db020d5e4dc89dfe02025-02-09T12:28:59ZengNature PortfolioScientific Reports2045-23222025-02-011511610.1038/s41598-025-88285-wUltrasonic characteristics of inserted central catheter related fibroblastic sleeveZhifei Ben0Jue Wang1Jinyong Zhan2Kaiying Xu3Department of Ultrasound, Ningbo NO.2 HospitalDepartment of Ultrasound, Ningbo NO.2 HospitalDepartment of Ultrasound, Ningbo NO.2 HospitalDepartment of Ultrasound, Ningbo NO.2 HospitalAbstract This study was aimed to summarize the ultrasonic characteristics of inserted central catheter (ICC) related fibroblastic sleeve, providing theoretical basis for its early diagnosis. Clinical and ultrasonic data of patients with ICC confirmed by pathology to have fibroblastic sleeves in our hospital from June 4, 2020 to April 1, 2024 were collected. All ICCs were made of polyurethane. Patients required the ultrasound evaluation due to local swelling and pain, abnormal coagulation function, lack of response to flushing of saline and heparin, or before extubation. The ultrasonic characteristics of fibroblastic sleeve such as its starting point, shape, thickness, internal echo, number of layers, relationship to the catheter, and presence or absence of thrombosis were analyzed. After the removal of the ICC, there was a membrane-like structure adhesion on the surface of the catheter, which was composed of endothelial cells, smooth muscle cells, collagen and fibrous connective tissues. A total of 95 patients with pathologically confirmed fibroblastic sleeve were present, of which 44 patients had only fibroblastic sleeves (46.32%) and 51 patients had fibroblastic sleeves with thrombi (53.68%). The fibroblastic sleeve originated from the site where the catheter contacted the vein wall and extended in a distal direction, with a thickness ranged between 0.7  and 5.6 mm. With the pathological results as the gold standard, the optimal cut-off value for the diagnosis of fibroblastic sleeve with thrombosis was 2.58 mm, and the sensitivity and specificity of the diagnosis were 95.45% and 96.08%. Compared to echogenicity of the catheter wall, hyperechoic or isoechoic fibroblastic sleeves were observed in 89 patients, while hypoechoic fibroblastic sleeves were observed in 6 patients. There were significant differences in the location of catheterization and duration of catheterization between the single-layer group and the double-layer group (P < 0.05). Fibroblastic sleeves were tightly attached to the catheter walls in 78 patients and loosely attached to the catheter walls in 17 patients, with significant differences in the location of catheterization and duration of catheterization (P < 0.05). ICC-related fibroblastic sleeves have specific ultrasonic characteristics. Understanding these ultrasonic characteristics can provide a reliable basis for their early diagnosis and timely treatment.https://doi.org/10.1038/s41598-025-88285-wUltrasoundInserted central catheterFibroblastic sleeve
spellingShingle Zhifei Ben
Jue Wang
Jinyong Zhan
Kaiying Xu
Ultrasonic characteristics of inserted central catheter related fibroblastic sleeve
Scientific Reports
Ultrasound
Inserted central catheter
Fibroblastic sleeve
title Ultrasonic characteristics of inserted central catheter related fibroblastic sleeve
title_full Ultrasonic characteristics of inserted central catheter related fibroblastic sleeve
title_fullStr Ultrasonic characteristics of inserted central catheter related fibroblastic sleeve
title_full_unstemmed Ultrasonic characteristics of inserted central catheter related fibroblastic sleeve
title_short Ultrasonic characteristics of inserted central catheter related fibroblastic sleeve
title_sort ultrasonic characteristics of inserted central catheter related fibroblastic sleeve
topic Ultrasound
Inserted central catheter
Fibroblastic sleeve
url https://doi.org/10.1038/s41598-025-88285-w
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AT juewang ultrasoniccharacteristicsofinsertedcentralcatheterrelatedfibroblasticsleeve
AT jinyongzhan ultrasoniccharacteristicsofinsertedcentralcatheterrelatedfibroblasticsleeve
AT kaiyingxu ultrasoniccharacteristicsofinsertedcentralcatheterrelatedfibroblasticsleeve