Analysis of 5 cases of PICC removal difficulty caused by fibroblastic sleeve.

OBJECTIVE

To explore the difficulties and solutions encountered during the removal of PICC catheters in five patients with a fibroblastic sleeve formation.

METHODS

This study includes five cases of PICC (peripherally inserted central catheter) removal difficulty caused by the formation of a fibroblastic sleeve. The patients were selected from a cohort with two cases involving the basilic vein in the right elbow fossa, two cases involving the brachial vein in the right elbow fossa, and one case involving the right cephalic vein. All patients underwent ultrasonography to exclude phlebitis and thrombosis.

RESULTS

The fibroblastic sleeve was identified as wrapping around the catheter's tip, leading to significant resistance during removal. The treatment approach involved thrombolysis, specifically using urokinase slowly injected into the catheter, combined with the application of a tourniquet. This method successfully facilitated catheter removal.

CONCLUSION

For patients with fibroblastic sleeve formation or catheter adhesion to the vessel wall, applying a tourniquet 11-15 cm above the puncture site may assist in successful PICC removal.