Peripherally Inserted Central Venous Catheter

FDA-Cleared Indications

• Prolonged intravenous administration of fluids, medications, or other therapeutic substances
• Central venous access when peripheral access is inadequate or repeated venipuncture should be avoided

Clinical Applications

• Long-term intravenous antibiotic therapy
• Administration of chemotherapy and other cancer treatments
• Delivery of parenteral nutrition
• Repeated intravenous medications or fluids requiring reliable central venous access

Reported off-label uses

• Administration of selected blood products or blood sampling when the catheter lumen and institutional protocols permit
• Extended outpatient intravenous therapy for conditions not specifically described in the individual product labeling

Off-label use: these uses are reported in practice or the literature but are not part of the FDA-cleared indications. Physicians may use a cleared device off-label based on their medical judgment; the manufacturer may not promote off-label uses.

Practical Considerations

• Common insertion sites include the basilic, brachial, or cephalic veins of the upper arm; the catheter tip is advanced toward the lower superior vena cava or cavoatrial junction.
• Catheter diameter, length, number of lumens, and maximum flow rate must match the prescribed therapy and the patient's venous anatomy.
• Use only compatible medications and flushing solutions; follow the manufacturer's instructions for placement confirmation, dressing changes, flushing, and maintenance.
• MRI safety depends on the specific catheter and any reinforcing components. Confirm the exact product's MR Safe, MR Conditional, or MR Unsafe labeling before scanning.
• Potential complications include infection, thrombosis, catheter occlusion, malposition, bleeding, venous injury, and catheter breakage or embolization. Avoid or use caution with severe upper-extremity venous thrombosis, local infection, or anatomy that prevents safe placement.