Abstract：
The prevalence of central venous catheters (CVC) in hemodialysis patients is around 20-30%. In this scenario, complications related to the use of the CVC are commonly observed, requiring active management by nephrologists. These include infectious complications as well as those related to CVC malfunction. Among the latter, the formation of a fibrin sheath around the catheter linked to foreign body reaction could cause CVC malfunction in various ways. Even after the removal of the catheter, the fibrin sheath can remain inside the vascular lumen (ghost fibrin sheath) and rarely undergo calcification. We describe the clinical case of a hemodialysis patient who, following the removal of a malfunctioning, stuck CVC, presented a calcified tubular structure in the lumen of the superior vena cava, diagnosed as calcified fibrin sheath (CFS). This rare occurrence, described in the literature in 8 other cases, although rare, is certainly underdiagnosed and can lead to complications such as sepsis resulting from CFS, pulmonary embolisms, and vascular thrombosis. Therapeutic approaches should be considered only in symptomatic cases and involve an invasive surgical approach.
摘要：
血液透析患者中中心静脉导管（CVC）的患病率约为20-30％。在这种情况下，通常观察到与使用CVC有关的并发症，需要肾病学家的积极管理。这些包括感染性并发症以及与CVC故障相关的并发症。在后者中,与异物反应有关的导管周围纤维蛋白鞘的形成可能以多种方式导致CVC功能障碍。即使在拔掉导管后,纤维蛋白鞘可以保留在血管腔内（幽灵纤维蛋白鞘），很少发生钙化。我们描述了一个血液透析患者的临床案例，在移除故障后，卡滞CVC,上腔静脉管腔内呈现钙化的管状结构，诊断为钙化纤维蛋白鞘（CFS）。这种罕见的情况，文献中描述了另外8个案例，虽然罕见，当然是诊断不足，可能导致并发症，如CFS引起的败血症，肺栓塞,血管血栓形成.治疗方法应仅在有症状的情况下考虑，并且涉及侵入性手术方法。
