A PICC line is a catheter that is inserted into a vein of the arm, typically above the elbow, and is threaded through this vein and stops just above the heart. PICC lines are very similar to central lines, the main difference is the site of insertion. There are a variety of configurations (single vs double lumen) and sizes of catheters that are placed.
Why is it done?
A PICC line is necessary when a patient needs medications given through their veins over an extended period of time. It is easier and less painful to have a PICC line placed than having to put a needle into a patient’s vein each time they need therapy. PICC lines are preferred over traditional IV’s because they can stay in longer, it is easier to draw blood from, and it allows for a wider range of medications to be administered.
While PICC lines and central lines are very similar in their function, some patients prefer the location of the PICC line and find it more convenient.
How is it performed?
Typically you are positioned laying on a bed.
The skin around the procedure site is cleaned. A local numbing medicine (anesthetic) is injected into the skin.
A needle is placed through the skin and into a vein of the upper arm.
A wire is advanced through the needle. Fluoroscopy (real time X-ray) is used to watch the position of the wire and confirm the correct location as it is advanced towards the heart.
A hollow sheath is advanced over the wire. Once in position, the PICC line is advanced through the sheath. Again, position is confirmed with fluoroscopic imaging.
The sheath is removed and the PICC line is bandaged in place.
What should I expect?
You may be asked to hold certain medications in preparation of your procedure.
During the procedure, you may be asked to hold your breath for short periods of time or to reposition your arm in order to ease the process of gaining venous access.
As the PICC is being placed, you may experience moments of discomfort or pressure in your arm and chest.
What is my recovery time?
Typically any symptoms you experience during or after your procedure should dissipate in 1-2 hours.
Avoid strenuous activity for 48 hours.
If you develop increased pain post procedure, seek immediate medical attention.
Although generally considered a low-risk intervention, complications of PICC line placement include: bleeding at puncture site, puncturing an artery, infection, or PICC line malfunction (typically if the line is moved out of position).