A central venous catheter (CVC) is a long, flexible tube your provider inserts into a vein in your neck, chest, arm or groin. It leads to your vena cava, a large vein that empties into your heart. A CVC helps you receive drugs, fluids or blood for emergency or long-term treatment. It also helps with blood draws. Types include PICC lines and ports.
A central venous catheter, also called a central line or CVC, is a device that helps you receive treatments for various medical conditions. It’s made of a long, thin, flexible tube that enters your body through a vein. The tube travels through one or more veins until the tip reaches the large vein that empties into your heart (vena cava).
Thus, your CVC’s tip is located in your vena cava. The other end is located just above or below your skin somewhere on your chest, usually on your right side. If it’s on the outer surface of your skin, it’s called a hub. You can see and feel the hub since it’s outside your body. If the other end is underneath your skin, it’s called a portal or reservoir. You can see and feel a small (quarter-sized) bump below your skin, but it’s not as noticeable. The hub or reservoir is the access point for your treatment.
A CVC allows your provider to access your bloodstream easily, reducing the need for many needle sticks into your vein. So, a CVC is ideal for people who need long-term medications, fluids, blood draws or blood transfusions. People who need emergency care or short-term treatments also benefit from CVCs.
Central venous catheters and intravenous catheters (also called peripheral IVs) both provide treatments and both devices enter your body through a vein. But they have three main differences:
Central lines and peripheral IVs enter your body through different veins. Central lines enter a large vein in your chest, neck, arm or groin. It’s usually a deep vein that’s not close to the surface of your skin. Peripheral IVs enter a vein close to your skin’s surface in your hand or arm.
When it comes to size, central lines are longer and have a bigger tube. That’s because they need to travel farther to reach their destination. Some central lines have more than one tube. These are called double or triple lumen catheters. They can accommodate different types of medicine in complex situations.
When it comes to duration, central lines can stay in your body longer than peripheral IVs. You usually need to change peripheral IVs every few days. But some types of central lines can stay in for weeks or many months.
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Central lines help people in many different medical situations, including people who need:
Providers also use CVCs during some medical tests.
Central venous catheters come in many forms. These include:
Your provider will tell you which type of CVC you need. It depends on your specific medical needs and how long you need the catheter.
A healthcare provider called a proceduralist performs placement of central lines. Proceduralists are physicians who specialize in certain medical procedures.
Central line placement is a common procedure. Millions of people receive a central venous catheter every year.
Three common access points for CVC placement include your:
PICC line access points include your basilic vein and cephalic vein, both located in your arm.
Each insertion site has advantages and disadvantages. Your provider will choose the best insertion site based on your condition and needs.
Your provider will explain the procedure to you, including its benefits and risks. You may ask any questions you have. Your provider will then ask for your consent to perform the procedure. In some emergency situations, this conversation isn’t possible.
Your provider will help you get into the proper position, which depends on the vein your provider needs to access. You’ll lie on your back, either completely flat or at a slight angle so your feet and legs are raised higher than your chest. Your provider will connect you to monitors that check your vital signs.
The procedure varies depending on the type of central venous catheter you need. If you need a non-tunneled CVC or a PICC line, you’ll have a percutaneous procedure. This means your provider punctures your skin with a needle to access your vein and insert the catheter. Your provider will perform the following steps.
Throughout, your provider may use ultrasound imaging technology to guide the procedure.
For tunneled CVC placement and port placement, your provider will use similar techniques to access your vein. But there are some differences you can expect.
Tunneled CVC placement requires a needle puncture plus surgery. You’ll receive local or general anesthesia to keep you comfortable.
Another main difference is that your catheter’s entrance and exit points are different. With a non-tunneled CVC or PICC line, the catheter leaves your body at the original vein access point. With a tunneled CVC, your provider chooses a different point where the catheter will leave your chest.
The catheter runs like an underground subway below your skin between the vein access point and the spot where it leaves your body.
Ports are also tunneled catheters, but the difference is that no part of the catheter comes out of your body. It’s entirely under your skin. You need a needle puncture plus surgery, and you’ll receive general anesthesia.
Your provider will make a small incision in your chest, in the area where your port will stay. This area will be close to the vein access point. Your provider will create a small pocket of space in your tissue just below your skin. They’ll insert the port into the pocket and sew it securely into place. Finally, your provider will sew the incision shut and apply a bandage.
Your provider will check to make sure the procedure was successful. They’ll perform a chest X-ray to confirm your CVC is in the proper place and that there are no complications. Your provider will tell you when you’re able to return home and give you instructions for what to do at home.
Your provider will also tell you how long you need your catheter and when you can have someone remove it. The length of time varies based on your medical needs and the catheter’s purpose.
A central venous catheter has many advantages over peripheral IVs, including:
The main complication of central venous catheters is infection. This is called a catheter-related bloodstream infection (CRBSI). It can occur during catheter placement or later on in your daily life. The risk for a CRBSI is higher if the catheter’s hub is outside your body, especially if you have a non-tunneled CVC or PICC line. The risk is also higher with more lumens in the CVC. Infection risk is lower for tunneled CVCs and ports.
Other complications that may occur during CVC placement include:
Complications that may occur after your procedure include:
Possible complications of central venous catheter removal include:
Your provider will tell you how to care for your catheter at home. It’s important that you follow these instructions to lower your risk of infection. You need to keep your CVC’s hub and the area around it very clean.
You may also need to visit your provider regularly so they can flush your CVC. This prevents blockages and blood clots.
Call your provider immediately if you have signs or symptoms of a CVC infection. These include:
Also call your provider right away if your catheter looks like it’s getting longer. This may signal that it’s coming out of your vein. If your catheter falls out or you remove it by mistake, please contact your provider right away.
Your provider will tell you how often you need to come in for CVC maintenance. Be sure to call your provider any time you have questions or concerns.
A note from Cleveland Clinic
Central venous catheters provide life-saving treatments in many different medical situations. If you need a central line, ask your provider which type is best for you, and why. Also ask your provider about the benefits and risks of your procedure and how to care for your catheter at home.
Last reviewed by a Cleveland Clinic medical professional on 07/28/2022.
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