PICCs

Peripherally inserted central catheter (PICC) is a flexible tube placed in a peripheral arm vein with the tip in the lower portion of the superior vena cava. It provides central venous access for medium- to long-term therapy, allowing infused medications, nutrition, and frequent blood sampling without repeated needle sticks.

Insertion is performed by trained clinicians under sterile technique, usually with ultrasound guidance. The catheter is threaded from a peripheral vein such as the basilic or cephalic vein into the central circulation and secured in place. PICCs are commonly made of polyurethane or silicone and sized around 4 to 6 French. Dwell time ranges from weeks to months depending on treatment duration and vein status.

Indications include antibiotics, chemotherapy, total parenteral nutrition, and repeated blood draws, or other therapies requiring reliable IV access. They can be used in outpatient settings and reduce the need for repeated venipunctures.

Benefits include convenient ongoing IV access and the potential for lower infection risk than some other central venous catheters, though PICCs have higher risks of thrombosis and vein irritation than peripheral IVs. Potential complications include infection, phlebitis, occlusion, dislodgement, catheter fracture, and, rarely, air embolism.

Maintenance involves regular flushing and dressing changes per protocol, hand hygiene, and monitoring for signs of infection or inflammation. Removal is performed by a clinician when therapy ends or complications arise; imaging may be used to confirm removal and assess for retained fragments.