What is a PICC Line?

A vascular access procedure involves placing a thin hollow plastic tube, or catheter, into a vein to permit drawing blood tests, and giving medications, fluids and nutrition, or transfusions directly into the bloodstream, over a period of weeks, months or even years.

The choice of type of venous access depends on the expected length of time it will be needed, as well as how often the device will be used.

A simple intravenous (IV) line is effective for a short-term use, but not suitable for more than a few days. When an IV line is necessary for a longer period, or for certain medications or nutrition that must be delivered into a very large, or central, vein where there is a large blood flow to dilute the medicine, then a central access catheter can be used. These catheters can remain in place either for a short time or for a long time, and can be easily and repeatedly accessed as needed.

A Peripherally Inserted Central Catheter (PICC) is a long catheter usually placed through a vein in the upper arm with its tip in a large central vein. These can remain in place for up to several weeks.

How should I prepare?

There is no special preparation required. Wearing a sleeveless shirt or undershirt may be helpful.

How is the procedure performed?

The procedure will be done in a special procedure room, on a fluoroscopy table where real-time X-ray imaging can be done to make sure the catheters are correctly placed. In some settings, a PICC line may be placed without fluoroscopy, and then a chest X-ray will be done afterward to check the position of the catheter.

You will be flat on your back, your arm will be outstretched to the side and a tourniquet is placed around the upper arm. Strict sterile technique will be used.

The skin will be cleansed with antiseptic, and a local anesthetic given. Ultrasound is used to find the appropriate vein. The PICC is then placed in this vein and the position is checked by fluoroscopy.

The outside portion of the PICC line will be fixed to the skin, usually with a special adhesive dressing.  

What will I experience during and after the procedure and how will I get my results?

The tourniquet may feel tight. Local anesthetic stings at the first moment of injection, but you should only feel pressure after that. You will need to keep the catheter covered with plastic wrap while showering. Do not swim or immerse the PICC in water. The PICC needs to be flushed with a blood thinner after every use. It can be removed by a nurse or other health care professional.

Immediately call your physician if any of the following occur:

  • Redness or swelling around the catheter or unexplained fevers
  • The catheter is pulled back or dislodged
  • The catheter malfunctions

The interventional radiologist will determine that the catheter has been placed correctly. At each use of the catheter, your health care professional will determine that the catheter is functioning by aspirating blood from the catheter before administering any medicine.

What are the benefits and risks?

A PICC allows blood tests to be taken, and medicines, fluids or nutrition to be given multiple times intravenously, without the need to have a separate venous puncture each time. The placement of the catheter tip in a large central vein allows some drugs that are toxic or irritating in very small veins to be used safely.

Patients can receive IV medications at home or in an extended care setting such as a nursing home. Any procedure that involves placing a catheter within blood vessels carries certain risks, such as bleeding and bruising, damage to the blood vessel, or infection. The vein containing the catheter may become clotted and cause swelling of the arm, shoulder or neck on the same side.

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