PICC Lines vs Other Central Lines: Weighing Your Options

Vascular access refers to the delivery of fluids and medication through the bloodstream.  When vascular access is required for longer periods of time, it may become problematic to continue placing new IVs.  Central lines – thin tubes inserted into veins for repeated vascular access – are then used.  There are many types of central lines, but one commonly used is the PICC (peripherally inserted central catheter). It is important to learn about PICC lines vs. other central lines and what might be best for you.

What is a PICC line?

A PICC line is a tube that a doctor or a nurse inserts into a vein around the elbow. It is long, thin, and hollow and is used when one requires chemotherapy, intravenous medication or fluids for a long period. It is also used when one requires frequent blood sampling.

For PICC lines, the doctor threads the catheter through your vein until it reaches near your heart, where the blood vessels get much larger and sturdier.  This is simply so that any irritation from the medications does not damage the thinner, more fragile parts of your vein (in your arm).  Before placing the catheter, an anesthetic is given to numb the area. After this, you will have an x-ray. The x-ray is done to check whether the catheter is in the right position.

There are various ways of maintaining a PICC line. A dressing that is changed every week helps to hold the PICC line in place and should be then protected by a PICC Line Cover.  Also, to reduce the risk of infection, the cap at the end of the line is replaced weekly. The line is regularly flushed to prevent it from blocking. Moreover, PICCs can not get wet, or they may cause infections. Patients have to be very careful when they shower. When you shower, you must use a shower sleeve that is waterproof, to prevent any water from coming in. 

For PICC protection, check out Mighty Well’s daily and waterproof PICC Line Covers here.

You can learn more about what to expect with your first PICC line here.

Below are my pros and cons of PICC lines based on my personal experience:

Pros of PICC lines

• The whole process is painless.
• They can be used for as long as they are needed, even at home.
• The risk of infection is low.
• PICC lines ensure that there is a low risk of irritation and blood vessel damage.

Cons of a PICC line

• Possible problems may include infection, blood clots, air in the PICC line, breaks and cuts of the tubes, and accidental disconnecting of the tubes.
• With a PICC line, activities like swimming and bathing are very difficult.
• You have to be very keen on hygiene.
• Some clothes might not fit normally.

There are also several PICC complications that may occur that you should be aware if you are getting this device placed. Wearing a well-fitting double-layer PICC Line Cover can help keep the catheter secured in place. By creating a pocket for the PICC to rest in between two layers, the external part of the PICC is not exposed, which helps to prevent possible dislodgement due to patient movement/activity.

But PICC lines are just one type of central line. Other central catheters include:

• Dialysis catheters
• Implantable ports (Inserted directly into your chest)
• Hickman lines

Some treatments may also be possible via peripheral catheters, such as PIVCs (Peripheral Intravenous Catheters) and Midlines (a shorter tube in your arm). If you want to learn more about PICCs vs. ports specifically, this blog outlines the pros and cons of each device on how they are both inserted.

There are various factors to consider when making a decision on which method best suits you. Consider the maintenance method, infection risks, the risk of drugs leaking into tissues, your ability to perform daily activities, and the exact purpose for which you need your line. Before meeting with your doctor to decide, think through each factor and write down any questions you may have. This decision is yours to make, and the more information you can gather – and the more you feel heard – the better the process will be!

Got more questions about the different types of central lines?  Check out our Educational Hub for more information.