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.

The insertion of a neck central venous catheter (CVC) is a common procedure in medical practice; however, malposition and complications frequently occur. A 66-year-old woman had CVC inserted through the right internal jugular vein. CVC malposition was observed on chest radiography and computed tomography. The catheter was accidentally inserted via the vertebral vein and had entered the C6-C7 intervertebral foramen, penetrating the spinal canal with the tip at the T2 epidural space. We present this rare CVC complication to demonstrate the possibility of incorrect insertion of the catheter and penetration of the spinal canal, possibly causing neuronal damage.