{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:41:18Z","timestamp":1783568478790,"version":"3.55.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T00:00:00Z","timestamp":1522108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives:<\/jats:title>\n                    <jats:p>We evaluated the location and structure of the fibrous sheath formed after the placement of tunneled, cuffed hemodialysis catheters in large animals, 70\u2009kg pigs. We focused on describing the location of the fibrous sheath in relation to the catheter. Its location explains the fibrous sheath\u2019s ability to cause catheter dysfunction by covering the catheter exit ports located at the catheter\u2019s tip.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We used three animals. Each animal had a tunneled, cuffed, 15-French diameter hemodialysis catheter placed in the external jugular vein, with the tip at the junction of the superior vena cava and the right atrium. Two animals were sacrificed at 5\u2009weeks and one animal at 17\u2009weeks after catheter placement. The catheter and surrounding tissues were removed in one block. The fibrous sheath was dissected and longitudinally cut along the catheter to evaluate its extension in relation to the catheter. Relevant portions of the fibrous sheath were sent for pathology examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The fibrous sheath covered the catheter in its entire length and circumference. It started at the entry site and continued without any interruption along the entire length of the catheter, including the tip. Its average thickness is 1\u2009mm and has an inner cellular\/inflammatory layer comprising lymphocytes, plasma cells, neutrophils, macrophages, multinucleated giant cells, and spindled cells and an outer layer comprising a mixture of collagen and fibroblasts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our model showed that the fibrous sheath forms around all catheters and covers them in their entire length and circumference without any gaps.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1129729818760978","type":"journal-article","created":{"date-parts":[[2018,3,28]],"date-time":"2018-03-28T00:53:56Z","timestamp":1522198436000},"page":"484-491","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Location and structure of fibrous sheath formed after placing a tunneled hemodialysis catheter in a large pig model"],"prefix":"10.1177","volume":"19","author":[{"given":"Marius C","family":"Florescu","sequence":"first","affiliation":[{"name":"Nephrology Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Runge","sequence":"additional","affiliation":[{"name":"UneMed Corporation, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurino","family":"Flora","sequence":"additional","affiliation":[{"name":"Chrysalis Medical, Inc., Hayward, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Nio","sequence":"additional","affiliation":[{"name":"Chrysalis Medical, Inc., Hayward, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lof","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Laboratory, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Stolze","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Laboratory, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Fry","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Laboratory, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley J","family":"Radio","sequence":"additional","affiliation":[{"name":"Pathology Department, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk W","family":"Foster","sequence":"additional","affiliation":[{"name":"Pathology Department, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,3,27]]},"reference":[{"key":"bibr1-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1177\/0148607196020002156"},{"key":"bibr2-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(98)70162-4"},{"key":"bibr3-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2402031129"},{"key":"bibr4-1129729818760978","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01910507"},{"key":"bibr5-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm536"},{"key":"bibr6-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2006.12.719"},{"key":"bibr7-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2003.12.004"},{"key":"bibr8-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(96)90495-3"},{"key":"bibr9-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61352-9"},{"key":"bibr10-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61353-0"},{"key":"bibr11-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61351-7"},{"key":"bibr12-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(96)70792-3"},{"key":"bibr13-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(97)80255-3"},{"key":"bibr14-1129729818760978","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.171.2.9694448"},{"key":"bibr15-1129729818760978","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.203.2.9114110"},{"issue":"3","key":"bibr16-1129729818760978","first-page":"369","volume":"26","author":"Voiculescu 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