Peripherally Inserted Central Catheter Line (PICC) lines and central lines allow patients to receive medication or nutrition without staying in a hospital. Some of these lines can be left in place for several months.

A tunneled dialysis catheter (TDC) is a dialysis access option for people who need dialysis therapy and may not be able to have a fistula or graft placed. The TDC can be used as soon as correct placement is confirmed. Sometimes people use a TDC temporarily while they wait for a fistula or graft to mature.

PICC Lines and Central Lines Can Administer:

• Antibiotics that must be taken through a vein over a period of time.
• Chemotherapy.
• Total parenteral nutrition (TPN) if you are unable to absorb food through your gastrointestinal system and need to be fed through a vein.

Tunneled Dialysis Catheters Are Used for:

• Hemodialysis for kidney disease.

Although each of these catheters has different characteristics, they all require a sterile environment for placement.

• A PICC line or central line can be placed in an exam or hospital room.
  • PICC lines are positioned in the upper arm.
  • A central line is positioned in the neck and around the collarbone, or occasionally in the groin.
• A tunneled dialysis catheter (TDC) needs to be placed in a room where a fluoroscopy test can be done. It is positioned under the skin in the neck and around the collarbone, or occasionally in the groin.

The procedure takes about 1–1-½ hours.

• An ultrasound test is usually done to identify the most suitable vein.
• The insertion site is cleaned. Numbing medicine is administered where the vein will be accessed.
• A small micro-puncture needle is used to enter the vein. A guide wire is then passed through the needle into the vein. The line or catheter is then inserted over the wire. The wire is then removed.
• An X-ray or fluoroscopy image is taken to confirm correct tip placement before the catheter is secured.

Possible complications from a PICC line include:

• Infection.
• blood clot in the central or superficial venous system

Possible complications from a central line include:

• Infection.
• Collapsed lung (pneumothorax), which can occur at the time of insertion. 

Possible complications from a tunneled dialysis catheter (TDC) include:

• Infection.
• A blood clot (thrombosis) that forms in the catheter and prevents or limits blood flow.
• A blood clot (central venous occlusion) that can block the large vessels in the chest and can cause chest and neck swelling. 
  • Often this can be corrected with a balloon angioplasty administered through the vein. A balloon device is slowly inflated inside the blocked portion of the vein to re-open the vessel and restore blood flow. 
  • Sometimes “clot busting” medications called thrombolytics are used with the balloon angioplasty to correct the blockage.
• The catheter can become dislodged or kinked.
• Collapsed lung (pneumothorax), which can occur at the time of insertion.

Call your healthcare provider if you develop any of the following symptoms:

• Temperature greater than 101.5F
• Shakes or chills.
• Chest pain.
• Shortness of breath. 
• Drainage from the insertion site. 

You may be asked to discontinue certain blood-thinning medications before the procedure.

• You may have some discomfort where the line or catheter is placed. This should resolve within a few days.
• It is important to keep the area around the access site for the catheter dry and clean. You should wash your hands before directly touching the line or catheter.
• Call your health care provider if you develop any of the following symptoms: temperature great than 101.5F, shakes or chills, chest pain, shortness of breath, drainage from the insertion site.