Fibrin Sheath Removal

Constant dialysis requires catheterization. When a person is using that catheter for an extended period of time, a fibrin sheath may grow around it. A fibrin sheath is a build-up of cells that eventually form a growing structure or material. This sometimes causes bad bacteria to grow and causes other health complications.

Methods

• The method for removing a fibrin depends on the patient. Some of the methods may be more disruptive than helpful, such as simply removing the catheter. Removing the catheter can take many attempts before being successful, and they take extra time and money to perform from a business standpoint, not to mention that the schedule for dialysis will be disrupted and cause more distress for the patient.

  Two methods that are more successful in this area without causing so much risk are the snare technique and the electric pulse technique. These both eliminate the fibrin sheath from within the body safely without any known complications.

Electroporation

• Electroporation occurs when cells are exposed to certain levels of electric pulses, which make the membrane permeable. This simply means that other substances can get through the membrane of the cell that otherwise could not. The electric pulses, if stopped too soon, will allow the cells to survive because the membranes return to normal and heal; however if exposed for the correct amount of pulses, cells will be destroyed.

  When thermal effects are added to the electrical pulses it is not only the cells that are killed. The structural tissue is also destroyed. By targeting fibrin sheathing with either reversible or irreversible electroporation, depending on the condition, with added thermal effects, the tissue and the cells are eliminated safely.

Internal Snare

• Using a 0.089 nitinol, wire bent into the shape of a loop is inserted by the catheter. When it exits through the lumen of the catheter, the snare is forced open by the wire. It disrupts the fibrin sheathing. which then separates and falls away into various pieces. The snare catches this debris and thus eliminates the fibrin sheath.

  This is a very direct solution for such a problem, does not require recovery time or anesthesia and has a high success rate. According to the National Center for Biotechnology Information, there are also no complications reported for this procedure and it is only minimally invasive to the patient. From the financial standpoint, it is also inexpensive, meaning that more patients can afford the treatment if necessary.