Interventional Procedures
PICC Line Insertion (X-Ray)

This provides an access route to deliver medication directly into the body without repeated injections.

Procedure

You will lie on the x-ray table with your arm out to the side. An ultrasound machine is used to identify a suitable vein in your upper arm to insert the PICC. This skin is then prepared as a sterile field with antiseptic on the skin and sterile drapes placed on your upper body.

A local anaesthetic is administered by a radiologist or specially trained nurse and a needle or short catheter placed in the vein. A small incision will be made, and the longer catheter advanced. You should not feel any sensation of the catheter inside your chest.

An x-ray is taken to confirm the correct position of the catheter tip.

Occasionally, x-ray contrast may be injected into the catheter to show the veins.

If it is not possible to advance the catheter on one side, it may be necessary to use the other arm.

Risks / Side effects

• Infection of the line or abscess formation at the puncture site is possible. This risk is minimised by performing the procedure under sterile conditions.
• Bleeding around the insertion site may occur immediately after the procedure and is stopped by applying pressure on the area.
• Clotting may occur in deep veins next to the catheter, called deep vein thrombosis (DVT). Rarely, they may break off and travel to the lungs, which is potentially fatal.
• The line may become blocked or leak, in which case it may need to be replaced.
• If x-ray contrast is administered, there is a small risk of an allergic reaction. A mild allergic reaction occurs in 1/1000 injections and includes a rash, hives or sneezing. More severe reactions such as difficulty breathing are less common. Severe life-threatening reactions are extremely rare (1 in 170,000).

Rarely, the procedure is not successful.

Before your Scan

You will be asked to change into an examination gown for your safety and comfort and to make sure your clothing does not affect the images or procedure.

You can eat and drink before and after the procedure. If you are on any regular medication or have diabetes and are on insulin, take your usual medicines and diet.

Please inform us if you are on medication to thin your blood (e.g. Warfarin, Aspirin or Clopidogrel), have an iodine allergy, or are pregnant or breastfeeding.

Other Information

After the procedure, some soreness and bruising may occur at the entry site.

There may be some ooze (blood) around the entry site for up to 24 hours which will be absorbed by the dressing and should stop. The dressing will be changed using sterile techniques and strict infection control practices to minimise infection.

The line should not get wet and will be covered with a clear dressing so you can still shower. Avoid hot water hitting this area directly.

The line will need to be flushed by trained staff regularly to prevent it from becoming blocked.

The line may stay in for several months. If you notice leakage around the line at the time of injection, inform the nursing staff caring for your line. The line may be split and need to be replaced.

Infection and clotting are potential complications. If you notice any arm swelling, localized redness, fever or increased pain, notify your referring doctor or nursing staff immediately.