A peripherally inserted central (venous) catheter (PICC line for short) is a type of long-term IV. It is placed in patients who need stable venous access for seven or more days. Common reasons they are placed are for extended IV antibiotics and total parenteral nutrition (TPN). PICC lines offer our patients comfort because all medications can be given through them, and labs can be drawn from them, allowing them to be poked/stuck less.
Most PICC lines are placed with little or no sedation; however, we do offer minimal and moderate sedation options and full anesthesia. There are no specific preoperative tests required before placing a PICC line. If moderate sedation or general anesthesia is being used, there will be instructions on how long the patient must fast before the procedure (somewhere between 2 to 8 hours).
To place a PICC, the patient will come into the interventional radiology suite and be positioned laying down on their back on our special table with their arm extended out at a 90-degree angle (on an arm board). The arm that is being used will be cleaned and sterile drapes placed over the insertion site and a tent made over the face (so the patient does not breathe on the sterile site and contaminate it). An ultrasound will be used to identify the target vein, and then local numbing medicine will be given. The ultrasound will then be used to guide the interventionalist into the vein. Once the vein is accessed, a wire will be placed into the vein, and the x-ray machine will be used to follow the wire along its path towards the heart. Measurements will be taken using the wire, and then the PICC line will be inserted over the wire. The wire is then removed, and a confirmatory x-ray is taken to ensure the PICC is in the right place (in the superior vena cava right next to the heart).
There will be a dressing covering the PICC insertion site. This dressing will need to be changed once every seven days or if the dressing becomes saturated or starts falling off. If you are going home with this line, then home health will be set up to take care of this for you. Do not submerge underwater (no baths or swimming) while this line is in. If/when you take a shower, please cover the dressing with Saran wrap or something similar to keep it dry. Watch out for signs of infection such as redness of the skin and purulent drainage. When the line is ready to be removed, it comes out very easily without the patient feeling it (just like an IV).