Which types of Central Venous Catheters (CVC) should be used when Peripheral Intravenous (IV) Catheters are not suitable or viable is dependent on various factors. The Central Venous Catheter is just another type of Vascular Access Device (VAD) and fortunately, the different types give the skilled clinician many treatment options. In general, it is somewhat similar to an IV Catheter but, it extends all the way to a large vein just above or below the heart.

When is a Central Venous Cather used?

A CVC is used instead of a Peripheral IV (PIV) when treatment is expected to be longer than 5 days as well as for other reasons as clinically indicated.  This line is used to deliver medications and therapies such as IV antibiotics, chemotherapy, and IV nutrition, directly to the heart, allowing prompt access to the bloodstream.  This helps preserve veins from medications that can be caustic. The CVC is also used for connection to a dialysis machine and blood withdrawal.

What are the types of Central Venous Catheters?

There are various types of CVC lines depending on which vein the line is placed for access.  These are usually the arm, chest, neck, and groin. In general, this is also the order in which they are evaluated as treatment options.  See Central Venous Catheter Lines | Vascular Wellness.

The PICC (Peripherally Inserted Central Catheter) is the only CVC that is peripherally inserted in the arm.  It is inserted just above the elbow and is guided around until it is just above the large vein of the heart, the Superior Vena Cava (SVC).  The PICC is the most used CVC.

The other CVCs access veins in or around the chest, neck or groin depending on the CVC. The vein used in the chest is either the axillary or subclavian. The axillary or chest CVC provides benefits if there is limited access to the upper arm such as in poor vasculature, quadriplegia, or injury.

The vein accessed in the neck is the Jugular.  The Jugular CVC provides benefits to those patients with limited access to the chest or arm area such as with breast cancer or those with risk of Lymphedema, Deep Vein Thrombosis DVT, chronic Kidney Disease, or upper arm cellulitis.  The vein in the thigh or groin area is the Femoral vein and is used when access to the SVC is blocked, by way of the Inferior Vena Cava, or simply, as an alternative to the Jugular CVC.

The type of line will depend on many factors such as medical history, including vein use, medical treatment, and activity level.  Provided no complications or other requirement for removal, it will stay until treatment completion.

The procedure is carefully performed using an ultrasound to guide the CVC needle to the vein and correct location, which is then verified using Electrocardiogram (ECG) or X-ray.

Another type of CVC is the Vas Cath for Dialysis.  This is a temporary hemodialysis catheter, placed in the Jugular or Femoral vein, that takes over the kidney function thereby allowing the kidneys to rest and heal.  This is the ‘pinch hitter’, if you will, of dialysis treatment.  In the case of Kidney Disease or Renal Failure, the kidney loses some amount of ability to function and filter out waste in the body.   A person experiencing this type of temporary or acute kidney failure such as due to an accident or medical condition, can have a Vas Cath inserted instead of a more intrusive procedure which is usually the AV Fistula and AV Graft used for dialysis.  Furthermore, if the more permanent AV Fistula or AV Graft becomes infected, a Vas Cath can be inserted to take over dialysis allowing the infection to fully resolve, before re-inserting another AV Fistula or AF Graft.

If you require a Central Venous Catheter, speak to the team at Vascular Wellness today.

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