J Korean Radiol Soc.  1995 Dec;33(6):861-864.

Placement of Peripherally Inserted Central Catheters (PICC): The Upper Arm Approach

• Lim JH
• Yoon JH
• Choo SW
• Choo IW
• Choi DI
• Hwang JW
• Andrews JC
• Williams D
• Cho KJ

Abstract

PURPOSE
To evaluate a recently developed technique to place a medium-duration(weeks to months) central venous access.
MATERIALS AND METHODS
Within three-year period, 635 patients were referred to interventional radiology suite for placement of peripherally inserted central catheter(PlCC). Contrast medium was injected into the peripheral intravenous line and a puncture was made into the opacified vein near the junction of the middle and upper thirds of the upper arm, either the brachial or basilic vein under fluoroscopic guidance. A 5.5-French peel-away sheath was inserted into the vein and a 5- French silicone catheter was introduced with its distal tip to the junction of the right atrium and superior vena cava.
RESULTS
Catheter placement was successful in all patients unless there was a central venous obstruction. Catheters were maintained from 2 days to 5 months with a mean of 3 weeks. Complications included infection requiring removal of the PICC in 16 patients(2.5%), acute thrombosis of the subclavian vein in 3(0.5%). Occluded catheters in 4 patients were easily cleared with urokinase in place.
CONCLUSION
The PICC system is an excellent option for medium-duration cen- tral venous access. Patients were able to carry on normal activities with the catheters in place.

MeSH Terms

Arm*
Catheters*
Heart Atria
Humans
Ocimum basilicum
Punctures
Radiology, Interventional
Silicones
Subclavian Vein
Thrombosis
Urokinase-Type Plasminogen Activator
Veins
Vena Cava, Superior
Silicones
Urokinase-Type Plasminogen Activator