{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:06:53Z","timestamp":1784531213530,"version":"3.55.0"},"reference-count":10,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"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":[[2026,7]]},"abstract":"<jats:p>Endovascular stenting is the standard of care for superior vena cava (SVC) obstruction, providing rapid symptom relief and high technical success rates. However, no guidelines exist for the concurrent use of centrally inserted central catheters (CICCs) within stents or for optimal antithrombotic strategies. We report a case of a 69-year-old woman with malignant Superior Vena Cava Syndrome (SVCS) treated with a central venous stent (CVS) placement who subsequently required a jugular CICC for antibiotic therapy. Six days later, she developed recurrent edema. Imaging revealed extensive thrombosis involving the stent and adjacent veins, while ultrasound demonstrated a prominent fibroblastic sleeve (fibrin sheath) at the catheter entry site. Despite thrombo-aspiration and catheter removal, the sleeve persisted, exhibiting the characteristic \u201cghost sign.\u201d Additional kissing stents restored partial patency, and anticoagulation was resumed.<\/jats:p>\n                  <jats:p>This case underscores the potential risks of placing a CICC within a previously inserted CVS. The coexistence of thrombosis and a fibroblastic sleeve on the same catheter\u2014reported here for the first time\u2014suggests that these entities, although distinct, can occur together. It is plausible that the flow reduction caused by the fibroblastic sleeve may increase the risk of thrombus formation, thereby raising the likelihood of stent thrombosis and recurrent SVCS. Imaging revealed that a fibroblastic sleeve, recognizable by the \u201cghost sign,\u201d persisted even after catheter removal, underscoring the diagnostic and therapeutic challenges of distinguishing it from thrombosis. Current guidelines do not address this situation, and data are limited. Until more evidence is available, clinicians should consider alternative access options\u2014such as Femorally Inserted Central Catheters (FICCs)\u2014when CVS are present and manage anticoagulation carefully. Multidisciplinary teamwork and regular follow-up are essential to improve outcomes and prevent recurrence.<\/jats:p>","DOI":"10.1177\/11297298261415969","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:56:26Z","timestamp":1770375386000},"page":"1870-1874","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The dangerous liaisons between central venous stents and catheters: a case report"],"prefix":"10.1177","volume":"27","author":[{"given":"Matteo Maria","family":"Masseroli","sequence":"first","affiliation":[{"name":"Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy"},{"name":"Universit\u00e0 degli Studi di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Torzillo","sequence":"additional","affiliation":[{"name":"Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5379-1091","authenticated-orcid":false,"given":"Antonio","family":"Gidaro","sequence":"additional","affiliation":[{"name":"Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy"},{"name":"Department of Biomedical and Clinical Sciences, Universit\u00e0 degli Studi di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Lazzaroni","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Milano, Milano, Italy"},{"name":"Respiratory Unit, Centre for Sleep and Respiratory Disorders, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Calloni","sequence":"additional","affiliation":[{"name":"Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Taino","sequence":"additional","affiliation":[{"name":"Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Casella","sequence":"additional","affiliation":[{"name":"Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy"},{"name":"Department of Biomedical and Clinical Sciences, Universit\u00e0 degli Studi di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Antonio","family":"Ianniello","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Ospedale Luigi Sacco, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Cogliati","sequence":"additional","affiliation":[{"name":"Internal Medicine, L. Sacco Hospital, ASST-fbf-sacco, Milano, Italy"},{"name":"Universit\u00e0 degli Studi di Milano, Milano, Italy"},{"name":"Department of Biomedical and Clinical Sciences, Universit\u00e0 degli Studi di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duccio","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Ospedale Luigi Sacco, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2021.08.016"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2016.12.1222"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241291248"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1129729820949411"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-88285-w"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241309164"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298231209253"},{"key":"e_1_3_2_9_2","article-title":"A GAVeCeLT consensus on the indication, insertion, and management of central venous access devices in the critically ill","author":"Pinelli F","unstructured":"Pinelli F, Pittiruti M, Annetta MG, et al. A GAVeCeLT consensus on the indication, insertion, and management of central venous access devices in the critically ill. J Vasc Access. Epub ahead of print 3 August 2024.","journal-title":"J Vasc Access"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2018.00004"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2024.02.004"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261415969","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298261415969","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261415969","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:47:55Z","timestamp":1784530075000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298261415969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/11297298261415969"],"URL":"https:\/\/doi.org\/10.1177\/11297298261415969","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,6]]}}}