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Tunneled CENTRAL Lines

Tunneled Central Lines are tunneled central venous catheters (CVCs) used to provide long-term access for medications, nutrition, hemodialysis, chemotherapy, and blood sampling. This page describes Tunneled Line Services, Placement, Use, Benefits, and Risks, as well as Tunneled Line Care and Maintenance. Vascular Wellness is one of very few Vascular Access nursing companies providing Tunneled Central Line Placement Services, and we believe the only one in the Southeastern United States, furthering our position as the most advanced and innovative vascular access company delivering clinical services to the bedside.

Tunneled Central Line Services

Tunneled Central Line Services by Vascular Wellness are provided by Vascular Access Board Certified (VA-BC) nurse clinicians. Tunneled central lines, also known as tunneled central catheters, can be either small bore or large bore lines and include PermCaths, which are used for hemodialysis during renal (kidney) failure. They are designed for longer-term use than non-tunneled CVCs. Using Ultrasound Guidance and catheter tip location technology in delivering Vascular Access Services, Vascular Wellness improves patient outcomes and decreases risks associated with these types of Catheter Insertions. In addition to Ultrasound guidance, Vascular Wellness clinicians often utilize single incision insertion and anti-microbial dressings on all Tunneled Line Services, further reducing risks of infection and other potential problems.

Ultrasound-guided line placement

Ultrasound-Guided Placement

Tunneled Central Line Placement

Tunneled Central Line Placement success is best achieved by expert clinicians using Ultrasound Guidance, as noted above, primarily because vein visualization is of the utmost importance. Vein visualization helps the clinician place the Tunneled Central Catheter on the first attempt while avoiding additional morbidities such as hematoma, inadvertent arterial cannulation, nerve injury, and pneumothorax, all while reducing the incidence of insertion-related infection. It is essential to assess the correct placement location for the Tunneled Central Line, and the clinician will make this determination after evaluating the patient. Placement is achieved by creating a small incision to place the catheter under the skin and into a vein. Tip confirmation will be performed at the end of the procedure, and a follow-up x-ray will be performed to ensure optimal outcomes.

Tunneled Line Use

Tunneled Line Use includes the delivery of chemotherapy, fluids, and nutrition. They are also used for blood draws and hemodialysis, often while patients wait for an arteriovenous fistula or graft to become functional. Tunneled Catheters can be utilized for a longer period of time compared to non-tunneled catheters due to a tissue ingrowth cuff that anchors the catheter and helps prevent bacteria from invading the bloodstream from the insertion site. Tunneled Line Use generally consists of catheters having 1 to 3 lumens, depending on the patient’s required therapies, and are secured using a sterile dressing.

Permcath internal jugular line illustration from Vascular Wellness, the vascular access experts

Permcath Internal Jugular Line Use for Hemodialysis

Tunneled Line Benefits

Tunneled Line Benefits are clear and compelling for clinically indicated patients since Tunneled Catheters can be accessed longer than other or central peripheral lines allowing patients with long-term vascular access needs to continue therapy even after being discharged from the hospital. Patients can resume normal activities a few days after the catheter is placed. Tunneled Catheters can have one or several infusion ports depending on the patient’s needs. When clinically appropriate, these Tunneled Line Benefits are persuasive, and ultimately, Tunneled Central Lines can provide a more comfortable and therapeutically flexible solution than non-Tunneled Lines.

Tunneled Line Risks

Tunneled Line Risks and placement complications are very low when a properly trained clinician performs the procedure with ultrasound guidance and care is taken to achieve an optimal tip position. After placement is confirmed, care must also be taken to avoid complications. This is best achieved by following good care and maintenance practices for the Tunneled Catheter. Complications can include bleeding, catheter migration, infection, and, in rare cases, air embolism. Careful placement practices significantly reduce bleeding risk at the exit site. Tunneled Line Risks are generally similar to those of central lines and, like central lines, can be mitigated with proper clinical policies and procedures in accordance with best practices.

Tunneled Line Care and Maintenance

Tunneled Line Care and Maintenance is essential, like central lines, and must be performed. Proper line care, maintenance, and dressing changes are performed in conformity with healthcare facilities’ policies and patient directions and involve everything, generally starting from inspecting the insertion site and the exit site. Prior to any contact with the access sites, patients must use aseptic techniques, and the catheter must be flushed to prevent clotting. Any signs of redness or irritation should be reported to your healthcare provider immediately. Tunneled Line Care and Maintenance is critical to the successful and ongoing use of the catheter.

Tunneled Line care and maintenance

Tunneled Central Line Care and Maintenance

Tunneled Catheters

For clarity, Tunneled Catheters are Tunneled Lines, and vice-versa. Medical and non-medical people use both terms often interchangeably as has been done on this page.


As Vascular Access Experts, Vascular Wellness nurse clinicians are Vascular Access Board Certified (VA-BC), insured, skill-verified, and salaried W2 employees. Vascular Wellness requires semi-annual skill verification, ensuring adherence to proprietary policies, procedures, competencies, and best practices. Vascular Wellness employs a Director of Research and Development who helps us stay up to date on best practices and also helps us continue to innovate and improve upon Vascular Access Services. In addition to Tunneled Catheters as central lines and for dialysis, some of these nursing advancements include Small Bore Axillary, Jugular, and Femoral Lines, Arterial Lines, and Large Bore Lines, including Quad Lumens.

Vascular Access Experts at Vascular Wellness

Vascular Access Experts practice holistic medical care, meaning talking to the patient, addressing questions and fears, and performing a comprehensive medical review. Prior to delivering any Vascular Access procedure, the Vascular Wellness clinician reviews the patient’s medical record, including history and lab reports, and independently verifies and confirms the doctor’s order. If our clinician has questions or disagrees with the prescribing doctor, the clinician will consult with the doctor. Our Vascular Access Experts have earned the trust of many doctors, and such doctors will defer to the clinician’s recommendation by ordering a “consult” as compared to a specific line. Patient safety and vein preservation are critical – which is why a holistic, comprehensive evaluation and Advanced Lines are significant. Other companies claiming to be Vascular Access Experts may not follow this same approach, frustrating medical doctors and nurses.

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Vascular Wellness provides comprehensive, quality, timely, and innovative vascular access services, including standard and advanced line placement, pediatrics, program management, education, training, and infection control and prevention to all healthcare settings such as Tertiary Hospitals, Community Hospitals, Long-Term Acute Care Hospitals, Hospital at Home Programs, Skilled Nursing Facilities, Surgical and Outpatient Centers, Hospice, and At-Home care. We support a 98+% Success Rate with 0% Insertion-Related Infection Rate across all lines, with an average response time of 3 hours. We help our clients improve patient outcomes, enable faster therapy, reduce costs, infections, and readmissions, decrease hospital length of stay, and reduce transportation expenses.

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