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Fibrin Sheath Removal Techniques 

Fibrin Sheath Removal Techniques
Chapter:
Fibrin Sheath Removal Techniques
Author(s):

S. Lowell Kahn

DOI:
10.1093/med/9780199986071.003.0045
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date: 30 September 2020

Although autogenous arteriovenous fistula creation is the gold-standard dialysis access, catheters represent between 40% and 60% of dialysis access in the United States. Catheters are placed for a variety of reasons, commonly as temporary access for acute renal failure or as a bridge to a more permanent access in patients with end-stage renal disease. Fibrin sheaths represent a heterogeneous matrix of cells and debris that form around catheters and are a known common cause of catheter failure and central venous stenosis. Their formation is ubiquitous in the dialysis population, occurring with 80–100% of catheters within 1 week of implantation. This chapter presents several techniques for the management of the fibrin sheath—the traditional catheter stripping technique, the internal catheter stripping technique, and the fibrin sheath angioplasty technique.

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