People with certain diseases or medical conditions sometimes require that tubes be placed into the body so that they can receive medications or nutrients directly into the blood stream or gastrointestinal system, or so blood can be drawn. In the past, surgery was required to insert these tubes, but today these procedures can be done by an interventional radiologist without surgery.
In a vascular-access procedure, a special catheter is inserted inside a major vein (generally in one of the large veins in the neck, arms or legs) with the tip of catheter positioned into a large central vein.
Often these procedures are performed for patients needing:
- intravenous antibiotic treatment
- chemotherapy or anti-cancer drugs
- long-term intravenous (IV) feeding for nutrition – infusion
- repeated drawing of blood samples
- Hemodialysis – a process used to treat patients whose kidneys are not working properly
- blood transfusions
Long term IV Access
A long term IV line is used when access is needed either temporarily (days) or long-term (weeks to years). This line offers a more secure venous access point and can be easily and repeatedly accessed over the necessary period of time.
A port catheter, or subcutaneous implantable port, is a permanent device that consists of a catheter attached to a small reservoir, both of which are placed under the skin similar to tunneled catheters. This catheter is placed completely under the skin.
Peripherally Inserted Central Catheter (PICC line)
A peripherally inserted central catheter (PICC) is a long catheter that extends from an arm vein into the largest vein (superior vena cava) near the heart and typically provides central IV access for several weeks, but may remain in place for several months. These catheters are called midline catheters when they are placed in a way that the tip of the catheter remains in a relatively large vein, but doesn’t extend into the largest central vein.
To place a PICC line, the physician will use ultrasound or X-ray guidance to insert a small needle into the arm vein and advance a small guide wire into the large central vein, called the superior vena cava. The catheter is then advanced over the guide wire and moved into position. The guide wire is then removed. If this is done without X-ray guidance, a chest X-ray is needed to confirm the catheter position.