If you have recently been asked to use a PICC line or may have any questions about it, this blog will help you better understand the uses, alternatives, benefits and risks associated with a PICC Line. However, as with any medical device or issue, your doctor is the primary point of contact for any issues.
What is a PICC Line?
A peripherally inserted central catheter (PICC) is a flexible catheter that is inserted in a peripheral vein in the arm. This catheter is then guided to a larger vein that eventually leads to the heart.
What is a PICC Line Used For?
A PICC line is typically used to provide long term treatment to a patient using a large vein near the heart. The most common use cases include providing:
- Peripheral (PPN) or total parenteral nutrition (TPN) for those that need to supplement or replace their nutritional requirements.
- Medications such as antibiotics to fight a serious infection
- Chemotherapy for treatment of cancers
How Long Can a PICC Line Stay In?
The duration of time depends upon the length of treatment, which typically ranges from weeks to months and is at the discretion of the treating physician.
Central Line vs PICC Line
A central line, also known as CVC (central venous catheter), is placed in the neck, chest, or groin. A PICC is typically placed in the upper arm, with its tip ending in a large vein that is close to the heart.
PICC Line vs Port
PICC lines and ports often serve the same purpose, but there are a few major differences:
- PICC lines stay in for a few weeks to a few months, but ports can stay in for up to several years.
- PICC lines need to be cleaned out daily, but ports only need to be cleaned about once a month.
- PICC lines can’t get wet, so they need to be covered when you bathe or shower. If you have a port, you can bathe and swim after it’s completely healed.
PICC Line vs IV
- IV lines are short and start and end in the arm, but PICC lines specifically end in the longest vein in your body.
- An IV can be left in your arm for up to four days, but PICC lines can stay for a few weeks to a few months.
- Certain chemotherapy treatments cannot be administered through an IV for safety reasons, and require a PICC line or CVC.
- Unlike an IV, a PICC line can’t get wet and must be cleaned daily
PICC Line Benefits
Mitigates the discomfort from the many needle sticks that are required of patients for continual medications and blood draws.
Allows for IV infusions to include certain medications that may irritate the small veins.
Can remain in place for an extended period of time patients that are in a hospital setting, nursing facility, or at home
PICC Line Risks
Common risks of PICC lines include:
- Bleeding may occur at the site of insertion
- Although it is a rare occurrence, there is a chance for accidental puncture of an artery, nerve, or tendon can occur near the insertion site. Leakage can occur due to skin elasticity, outward line migration, or line rupture
- Infection may occur at the insertion site or in the bloodstream
- PICC line malfunction from the line getting clogged. Medications are available to clear the line, but may not always work leading to PICC line removal.
- Partial or complete removal of the PICC if not well-secured and completely covered. The use of a PICC Line Cover can help prevent this from happening.
Rarer more infrequently occurring risks include:
- tamponade, secondary to vessel wall damage
- atrial or ventricular perforation
- bacteremia, septicemia, arrhythmias
PICC Line Cover
A PICC line cover is a sleeve, generally made of fabric that is worn over the PICC’s medical dressing. The cover provides coverage and protection to prevent pulling and/or displacement of the PICC. The cover allows patients to securely cover their PICC lines and helps conceal it in a dignified fashion.
PICC Line Alternatives
The TIVAD (totally implantable vascular access device) is a long hollow tube that is inserted into one of the large veins in the body. TIVADS are also called Ports or Portacaths. Another PICC line alternative is the Tunneled CVC (central venous catheter). A CVC is a long flexible tube that is generally inserted in the vein below the collarbone.
Reviewed by :
Anand Prabhakar, MD, a practicing radiologist at Massachusetts General Hospital