Peripherally/Centrally Inserted Central Catheter (PICC & CICC)

Placement of a catheter in your blood vessel to provide long term access for treatment and blood sampling.

What is a Peripherally Inserted Central Catheter (PICC)?

The PICC is a small catheter (tube) that is inserted by an interventional radiologist. It is placed into a vein in your arm. This can be the left or the right arm depending on the quality of your blood vessels. The PICC is made of a special material that is sterile and durable, making it suitable for long term use. The PICC can have 1 or 2 (sometimes 3) access points called hubs. These hubs can be used for injecting medication but can also be used to draw blood. The PICC is often used in people who need types of treatment that require long term blood vessel access. The PICC line is visible at the insertion sites, and regular care is needed to make sure the line stays sterile and works.

What is a Centrally Inserted Central Catheter (CICC)?

The CICC (like the PICC) is a small catheter (tube) that is inserted by an interventional radiologist. It is placed into a vein in your neck. This can be the left or the right side of your neck depending on the quality of your blood vessels. The CICC is made of the same material as a PICC making it suitable for long term use. The CICC can have 1 or 2 (sometimes 3) access points called hubs. These hubs can be used for injecting medication but can also be used to draw blood. The difference between the PICC and the CICC is that the CICC is placed under the skin below your clavicle. The size of the CICC is usually somewhat bigger than a PICC. Like a PICC, the CICC is often used in people who need types of treatment that require long term blood vessel access. The PICC line is visible at the insertion site below your clavicle, and regular care is needed to make sure the line stays sterile and works.

Who May Benefit?

The treatment to insert a PICC/CICC is made together with your treating physician. People that may benefit from a PICC/CICC insertion are:

1. People needing long term antibiotics
2. People needing frequent blood sampling but have difficult veins to access
3. People needing frequent transfusions
4. People needing chemotherapy

How Is the Procedure Performed?

1. The procedure is performed by a specialist interventional radiologist
2. Done under local anaesthesia, and sometimes with mild sedation
3. A sterile field is created around your upper arm in case of a PICC, or just below your clavicle and in the neck in case of CICC
4. The vein that will hold the tube is accessed (this can be right or left)
5. A small tube is guided under your skin from the insertion site into the blood vessel. Most of the tube will be situated under the skin and is not visible
6. Using real-time X-ray guidance, the small tube is placed just above the heart
7. The PICV/CICC is accessed to make sure it works properly
8. The PICC/CICC will be secured to the skin to make sure it doesn’t move
9. The procedure usually takes about 30-45 minutes and is performed as a day-stay treatment or in some cases as a walk-in/walk-out procedure

Benefits

1. Long term access to your veins
2. Quick recovery – most people return to activity the next day or within a few days
3. Proven safety and efficacy in clinical studies

Risks and Side Effects

Complications are uncommon but may include:

1. Mild bruising or tenderness around the insertion site
2. Infection of the PICC/CICC, this requires removal and replacement as well as additional antibiotics
3. Blood clot formation in the line or in the vein, often requiring removal of the line and replacement.
4. Disturbances of your heart rate when the tube is too close to the heart

After the Procedure

1. Most people go home the same day
2. Light activities can resume within a day to a few days
3. You can shower and bathe as long as the dressings and the PICC/CICC stays dry. It is recommended not to swim with the PICC/CICC.