Peripherally Inserted Central Catheter (PICC) Line Placement

Under the guidance of fluoroscopy (a type of X-ray that can see motion in real time), your doctor will locate the large vein in your upper arm and insert a small needle. Your doctor will then feed a small guide wire through the vein to the superior vena cava. Once the wire is in place, a peripherally inserted central catheter (PICC) is inserted over the guide wire and moved into position. The specific length of the catheter is then determined based on your body habitus. The guide wire is then removed, and the external portion is secured to your arm.

When you arrive for your procedure, a member of our clinical team will greet you and bring you into an exam room. You will be asked to empty your bladder and change into a gown.

The technologist will bring you into the procedure room and position you on the table. Using the guidance of ultrasound, your doctor will find the appropriate location to insert the PICC line. Your doctor will numb the area with a local anesthetic. Once the area is numb, your doctor will make a very small nick at the insertion site, and you may feel some pressure as the guide wire and catheter are inserted, but you won’t feel any serious discomfort.

Once the catheter is in place, the wire will be removed. Pressure will be applied to stop any potential bleeding and the catheter will be taped in place on your arm. You will not need stitches. The procedure usually takes 30 to 40 minutes. When you feel ready, you will be able to go home.

You may feel some discomfort after the procedure. This can usually be treated with over-the-counter pain medications. Please tell your doctor if you experience any swelling or major discomfort, or develop a fever.

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Some other things to keep in mind in planning for this procedure include:

• Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), or blood thinners (such as Coumadin or warfarin) for a time before the procedure.
• When you arrive, make sure the nurse and radiologist know about any allergies you may have, especially allergies to local anesthetics or contrast material.
• If there’s any chance you may be pregnant, tell your radiologist.

On the day of your procedure you should:

• Wear comfortable, loose-fitting clothes.
• Wear comfortable shoes.
• Avoid bringing jewelry or valuables.

The benefits of a PICC Line Placement may include:

• Allows medication to be given without certain complications associated with IV lines, such as irritation of the vein walls or tissue damage if a toxic drug leaks out of the vein.
• Eliminates repeated needle sticks for patients undergoing ongoing treatment or therapy.
• Facilitates blood draws and blood tests without the need for repeated needle sticks.
• Eliminates the side effects of repeated IV lines such as scarring of arm veins.
• PICC lines are easily removed once they are no longer needed.

Some risks that you should be aware of include:

• Like any procedure that involves a catheter, there is a risk of damage to blood vessels, bruising, bleeding, or infection at the puncture site.
• There is also a risk of blood clots forming in the veins in your chest.
• Proper care, such as flushing the line, is necessary to reduce the risk of infection and ensure the line remains functional.

Keep in mind that this information is general. Your radiologist or doctor is the best source of information about how these risks and benefits may apply to you.