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Summary

A central venous catheter (CVC) is a catheter that is placed in a vein in the arm or hand or through a catheter implanted in a larger vein in the chest, neck or arm during surgery. It can stay in place. Drugs can be injected directly into the CVC, or through an IV connected to the CVC. Blood can also be drawn from these catheters.

A CVC is an alternative to catheters and needles which can scar or weaken veins with ongoing chemo.

There are a variety of ways drugs can be delivered through a CVC.

There a variety of types of CVCs. Which is the best to use for a particular patient depends on a variety of factors. Your doctor can help you decide if you need a CVC, and the right type of CVC for you.

NOTE: Emotionally, a CVC can become a constant reminder of your health condition because it protrudes from your body 24/7. If your emotions make your life difficult, talk with your doctor.

Why Central Venous Catheters (CVCs) Are Used

CVCs are used for these reasons:

  • To give several drugs at one time.
  • For long-term therapy (to reduce the number of needle sticks).
  • For frequent treatments (using a CVC won't cause as much wear and tear to the veins, potential scarring, and discomfort as numerous IVs).
  • For continuous infusion chemotherapy.
  • To give drugs that can cause serious damage to skin and muscle tissue if they leak outside of a vein (these drugs are known as vesicants). Delivering these through a CVC provides more stable access to a vein than a regular IV, reducing the risk that the drug will leak outside the vein and damage tissues.

How Drugs Are Given Through A CVC

Intravenous drugs are given through a CVC in these ways:

  • The drugs can be given quickly through IV tubing right from a syringe over a few minutes; this is called an IV push.
  • An IV infusion can last 30 minutes to a few hours. A mixed drug solution flows from a plastic bag.
  • Continuous infusions are sometimes needed and can last from 1 to 7 days

Types Of Vascular Access Devices

There are many different types of CVCs that can be used to allow an easier route for IV medicines. These CVCs have different types of catheters and ports. The type of CVC used is based on:

  • How long you will be getting treatment.
  • How long it takes to infuse each dose of chemotherapy.
  • Your preferences.
  • Your doctor's preferences.
  • The care required to maintain the CVC.
  • And its cost.

Type of Device

Comments

PICC (peripherally inserted central catheter)


(Per-Q-Cath, Groshong PICC)

Inserted in a vein in the arm and threaded up near the heart. An intermediate-term catheter which allows for continuous access to peripheral vein for several weeks to months. No surgery needed. Care of catheter needed.

Midline catheter
(Per-Q-Cath Midline, Groshong Midline)

Also placed in a vein in the arm, but the catheter is not threaded as far as a PICC. A short-term catheter used for intermediate length therapy when a regular peripheral IV is not advisable or available. No surgery needed. Care of catheter needed.

TCVC (Tunneled Central Venous Catheter)
(Hickman, Broviac, Groshong)

The catheter can have multiple lumens (openings) and is surgically placed in large central vein in the chest. The catheter is tunneled under the skin, but the lumens remain outside the body. This is a long-term catheter that is good for months to years. Site care of external catheter and regular flushing is needed.

Implantable Venous Access Port
(Port-A-Cath, BardPort, PassPort, Medi-port)

A port of plastic, stainless steel, or titanium with a silicone septum. This drum-shaped device is surgically placed under the skin of the chest or upper arm. The attached catheter extends into a large or central vein. The port is accessed by a non-coring needle. It is intended for long-term use. No routine care is needed when not in use, although it may need to be flushed if not used for more than a month at a time.

Implantable pump

A titanium pump with an internal power source surgically implanted to give continuous infusion chemotherapy, usually at home. There is a refillable reservoir for continuous infusions.