Vascular access is a way to repeatedly or continuously give you medication, fluids, blood products, or nutrition, and to draw blood for tests, without the need for frequent needle sticks in smaller veins.
| Device | Insertion Site | Typical Duration |
| Central Venous Catheter (CVC) / Central Line | A large vein in the neck (Internal Jugular), chest (Subclavian), or groin (Femoral). | Short-term (days to a few weeks) |
| Peripherally Inserted Central Catheter (PICC) / PICC Line | A vein in the arm (usually the upper arm). | Medium to long-term (weeks to months) |
2. Benefits of Having a Central Line or PICC Line
These devices provide many advantages over traditional peripheral intravenous (IV) lines:
- Long-Term Access: Can stay in place for extended periods, avoiding multiple needle pokes.
- Safe for Certain Medications: Allows for the delivery of concentrated or irritating medications (like some chemotherapy drugs or highly concentrated nutrients/Total Parenteral Nutrition – TPN) which can damage smaller peripheral veins.
- Reliable for Blood Draws: Makes frequent blood sampling easier.
- Delivery of Multiple Treatments: Many lines have multiple channels (lumens) to allow for different medications to be given at the same time without mixing.
- Improved Patient Comfort: Studies show that a PICC line can result in favorable patient-reported satisfaction and comfort compared to repeated standard IV access.
3. Risks and Potential Complications
While highly beneficial, these procedures have risks. Your healthcare provider believes the benefits outweigh these potential risks.
| Complication | Risk Percentage (Approx.) | Description |
| Infection | CVC: Approx. 4.8 per 1000 catheter-days (Serious bloodstream infection). PICC: Approx. 1.6 to 2.3 per 1000 catheter-days (Bloodstream infection); Overall infection rate around 6% to 15% of patients. | A local or bloodstream infection (CLABSI or PICC-BSI). This is a serious risk and requires strict hygiene/care. |
| Blood Clot (Thrombosis) | CVC: Approx. 2.7 per 1000 catheter-days. PICC: Can be as high as 1.6% to 40%, but often minimal and not clinically significant. Symptomatic clots are less common. | A clot forms in the vein around the catheter, which can cause arm/neck swelling and pain. Rarely, it can travel to the lungs (Pulmonary Embolism). |
| Mechanical Complications | CVC Insertion: Overall ≈ 3% risk of major complications (e.g., pneumothorax, arterial cannulation) | Catheter blockage (occlusion), breakage, or accidental movement/dislodgement. |
| Pneumothorax (Collapsed Lung) | CVC (Insertion Risk): Approx. 4.4 per 1000 insertions (higher for chest/subclavian CVCs). PICC: Risk is extremely rare. | Air enters the space between the lung and chest wall, often requiring a tube for drainage. |
| Arterial Injury | CVC (Insertion Risk): Puncture ≈ 16 per 1000 insertions. Cannulation ≈ 2.8 per 1000 insertions. PICC: Rare. | Accidental puncture or cannulation of an artery near the insertion site. |
| Irregular Heartbeat (Arrhythmia) | Rare | Can occur during insertion if the catheter tip irritates the heart. It usually resolves on its own. |
4. What to Watch For
Contact your healthcare team immediately if you notice any of the following signs of a complication:
- Fever or Chills: A temperature above 100.4∘F or 38∘C.
- Redness, Swelling, Pain, or Warmth at the insertion site or along the arm/chest/neck.
- Pus or Discharge coming from the insertion site.
- Sudden Swelling in the arm, hand, neck, or face.
- Shortness of breath or persistent chest pain.
- The catheter is broken, cracked, or has come out partially or completely.
- The catheter is blocked and fluids will not go in or blood cannot be drawn.
5. Caring for Your Line
- Keep the dressing clean and dry. Your nurse will teach you how and when to change it.
- Wash your hands thoroughly before touching the catheter or dressing.
- Avoid submerging the line in water (no swimming, baths, or hot tubs). Follow your nurse’s instructions for showering.
- PICC Lines: Avoid heavy lifting (over 5-10 lbs) or strenuous, repetitive arm movements on the arm with the PICC.
Sources:
Teja, B., Bosch, N. A., Diep, C., et al. (2024). Complication rates of central venous catheters: A systematic review and meta-analysis. JAMA Internal Medicine, 184(5), 474-482.
Peripherally inserted central catheter (PICC) line. (2025). Mayo Clinic. Retrieved from https://www.mayoclinic.org/tests-procedures/picc-line/about/pac-20468748
Peripherally inserted central catheters in critically ill patients. (2018). ScienceOpen. Retrieved from https://www.scienceopen.com/document_file/5a59321b-52d8-436a-b78e-e885de83bb0a/PubMedCentral/5a59321b-52d8-436a-b78e-e885de83bb0a.pdf
Perils of the PICC: Peripherally Inserted Central Catheter-Associated Complications and Recommendations for Prevention in Clinical Practice—A Narrative Review. (2025). MDPI. Retrieved from https://www.mdpi.com/2227-9032/13/16/1993
Safety, Efficacy, and Patient Satisfaction with Initial Peripherally Inserted Central Catheters Compared with Usual Intravenous Access in Terminally Ill Cancer Patients: A Randomized Phase II Study. (2020). Cancer Research and Treatment. Retrieved from https://www.e-crt.org/journal/view.php?number=3195