A Peripherally Inserted Central Catheter (PICC) is a narrow plastic tube inserted into a vein in the arm with the tip of the tube positioned close to the heart.

This provides an access route to deliver medications directly into the body without repeated injections.

Procedure

You will lie on the x-ray table with your arm out to the side. An ultrasound machine is used to identify a suitable vein in your upper arm to insert the PICC. This skin is then prepared as a sterile field with antiseptic on the skin and sterile drapes placed on your upper body.

Local anaesthetic is administered by a Radiologist or specially trained nurse and a needle or short catheter placed in the vein. A small incision will be made and the longer catheter advanced. You should not feel any sensation of the catheter inside your chest.

An X-ray is taken to confirm correct position of the catheter tip.

Occasionally X-ray contrast may be injected into the catheter to show the veins.

If it is not possible to advance the catheter on one side it may be necessary to use the other arm.

Risks / Side Effects

  • Infection of the line or abscess formation at the puncture site is possible. This risk is minimised by performing the procedure under sterile conditions.
  • Oozing of blood around the insertion site may occur immediately after the procedure and is stopped by pressure on the area.
  • Clotting may occur in deep veins next to the catheter (DVT). Rarely, they may break off and travel to the lungs, which is potentially fatal.
  • The line may become blocked or leak in which case it may need to be replaced
  • If X-ray contrast is administered there is a small risk of allergic reaction. This includes flushing, hives and difficulty breathing. Severe reactions are rare and life-threatening reactions are extremely rare (1 in 170,000).

Infrequently, the procedure may not be successful.

 

Before your Scan

No specific preparation is required and you may eat and drink before and after the procedure. If you are on any special drugs or have diabetes and are on insulin, take your usual medicines and diet.

Please inform us if you are on medication to thin your blood (eg. Warfarin, Aspirin or Clopidogrel), have an iodine allergy or are pregnant or breastfeeding.

Other Information

After the procedure, some soreness and bruising may occur at the entry site.

There may be some ooze around the entry site for up to 24 hours which will be absorbed by the dressing and should cease. The dressing will be changed using sterile technique.

The line should not get wet and will be covered with a clear dressing so you can still shower. Avoid hot water hitting this area directly.

The line will need to be flushed by trained staff regularly to prevent it becoming blocked.

It may stay in for several months. If you notice leakage around the line at the time of injection, inform the nursing staff caring for your line. The line may be split and need to be replaced.

Infection and clotting are potential complications. If you notice any arm swelling, localized redness, fever or increased pain notify your referring doctor or nursing staff immediately.