Central Port, PICC Line - Central Venous Catheters -

What is a Central Venous Catheter?

Central venous catheters (CVCs) are also called central venous access devices (CVADs), or central lines. They are used to put medicines, blood products, nutrients, or fluids right into your blood. They can also be used to take out blood for testing.

Why would you need a CVC?

Reasons you might need a CVC:

To get more than one drug at a time
To get continuous infusion
To get nutrition such as TPN (total parenteral nutrition)
To get frequent treatments
To get long-term therapy (over many months or even years)
To get drugs that can cause serious damage to skin or muscle tissue if they leak outside a vein.

Many different kinds of CVCs are available. The 2 most common types are the central port and the PICC line.

What’s a Port?

A port is a type of central venous catheter. It also called an implantable venous access port. It’s a small “puck” made of plastic or metal with a thin tube (the line) going from the puck into a large vein. Ports are permanently placed in a pocket under the skin of the chest between muscle tissue or arm during surgery. The puck has a silicone septum (self-sealing membrane) across the top and special needles are stuck through the skin into the septum to use the port. Single and double ports are available. A single port is shown in the picture below; a double port has two septums attached to each other.

A port can stay in for many years. It doesn’t require any special care when there’s not being used. Once the area around it has healed, you can bathe, shower, or even swim.

Some brand name Port-A-Cath^®, BardPort^®, PassPort^®, Medi-port^®, PowerPort^®, and Infusaport^®.

How is a Port Inserted?

Ports are usually placed on the chest wall. A small incision is made in skin on the front of the chest and a “pocket” is created under the skin for the port. Using ultrasound guidance, access is gained to the vein in the neck, via a small (5mm) incision. The tube (catheter) is then fed through the vein until the tip of the catheter is sitting in one of the large veins in your chest. A small tunnel is made in the skin for the tube to pass through and the other end is connected to the port. Correct positioning of the catheter is confirmed by fluoroscopy (using x-ray). The incisions under the collar bone and the side of the neck closed with dissolvable sutures (stitches) and a small sterile dressing is put in place.

What is a PICC Line?

PICC A PICC line is a Peripherally Inserted Central Catheter used for various medical purposes. It consists of a long thin tube being inserted into your upper inside portion of your arm. You can then deliver fluids and medicines through this port as well as draw blood. The tube terminates in a large vessel near your heart and at the other end of the tube (the portion coming out of the arm) there is either one or two lumens. A PICC line can be left in for weeks or months depending on how your body reacts to the PICC.

How is a PICC inserted?

A PICC line can be placed as an outpatient procedure by either a radiologist or a PICC team. First the PICC team will use an ultrasound to find the vein they want to access. Once they have picked the vein, they will swab the area with surgical antiseptic (don’t know what this is actually called) and then numb the area. The numbing medicine stings badly for about 30 seconds, but after they are done numbing you shouldn’t feel much of anything. They then insert a needle into the vein and use a cannula to thread the tubing into the arm till the tubing reaches the endpoint. Next they remove the needle and cannula and secure the PICC line in place. Overall it is a fairly painless procedure if done correctly and all goes smoothy.