"We hypothesize that thrombus formation in this case resulted from a combination of factors. First, ultrasound video revealed extravascular tissue being pulled into the vessel during dilator insertion, potentially exposing circulating blood to tissue factor (the image at 32 s and diagram in the supplement video). Second, the patient’s severely reduced EF may have caused venous stasis" Uchiyama and Tsubokawa (2025).
Sudden thrombus formation detected during central venous catheter insertion

Extract:

“We hypothesize that thrombus formation in this case resulted from a combination of factors. First, ultrasound video revealed extravascular tissue being pulled into the vessel during dilator insertion, potentially exposing circulating blood to tissue factor (the image at 32 s and diagram in the supplement video). Second, the patient’s severely reduced EF may have caused venous stasis. EF reduction is a known independent risk factor for thromboembolic events. Third, patients with dilated cardiomyopathy or low EF often show elevated coagulation markers, suggesting a hypercoagulable state. The interaction of these factors may have facilitated the immediate thrombus formation observed during dilator advancement.”

Reference:

Uchiyama K, Tsubokawa T. Sudden thrombus formation was detected during real-time ultrasound-guided central venous catheter insertion. JA Clin Rep. 2025 Aug 22;11(1):45. doi: 10.1186/s40981-025-00808-6. PMID: 40844761.