Central Venous Catheters

Avoiding Getting Stuck With a Chemo Needle Takes Some Extra Work

A central venous catheter (CVC) is one type of long-term vascular access device. Like implanted ports, you'll have a line of tubing inside an arm or chest vein that will go all the way to your heart. A port is completely under your skin, but a central venous catheter extends two to four inches outside your skin and ends in external injection caps. A central venous catheter can stay in place from six weeks to many months. This type of catheter is sometimes called a tunneled intravenous catheter.

CVC Basics

Central Venous Catheter CVC Detail
Central Venous Catheter CVC Detail. Art © Pam Stephan

Central venous catheters (CVCs) are one way to take long-term intravenous chemotherapy.  From the outside, a CVC looks like a PICC line or a midline cather, because it extends outside your skin and ends in one or more external injection caps.  The injection caps are used to give you chemotherapy, antibiotics, saline, and other fluids. You won't be stuck with an IV needle with a central venous catheter, because your infusion nurse will use the catheter's extension caps to give chemo drugs or other fluids.

Insertion Of Your Central Venous Catheter

Central Venous Catheter CVC For Chemotherapy
Central Venous Catheter CVC For Chemotherapy. Art © Pam Stephan

You may have light sedation when your central venous catheter is placed into your central vein, to be certain that you don't move during the procedure.  The catheter line will be tunneled under your chest skin and then inserted into an internal jugular vein or a vein just beneath your collarbone (subclavian vein), then threaded into a large vein near your heart.  An ultrasound may be used to confirm the position of the tip of your central venous catheter.  Outside the insertion point, a short length of catheter will be anchored to your skin and a dressing applied to stabilize it.

Compare Implanted Ports With Central Venous Catheters

Both ports and central venous catheters are vascular access devices (VADs) that have tubes to protect your veins and extend all the way to a central heart vein.  If you don't mind getting stuck with a needle for each chemotherapy infusion, then an implanted port may work well for you.  An implanted port is completely under your skin and has a low risk of infection.  But if you dread getting stuck with needles, then a central venous catheter might be more appealing.  However, the CVC will require you to do some maintenance:  flushing, fresh dressings, and changing the external injection caps. Central venous catheters are more prone to infections – the most worrisome type being a bloodstream infection.

Also Known As:

Central line, CVC, central venous line, central venous access catheter, tunneled intravenous catheter, Broviac, Groshong, or Hickman Catheter

CVC Uses

Your central venous catheter can be used for blood draws, if your infusion nurse is trained to do that. A CVC may also be used for chemotherapy, antibiotics, saline, pain medications, and liquid nutrition.

Precautions With Your Central Venous Catheter

Your infusion nurse will teach you how to maintain your central venous catheter at home. Keep the external injection caps sterile and dry.  Protect and clean the exit site of your catheter line, and check it for redness and swelling.  Don't twist the catheter line or pull on it – if the tube become kinked or damaged it may no longer work, and will have to be replaced.

When to Call For Help

Keep an eye on the exit site of your catheter – if it continues to bleed for some time after it has been inserted, call for help.  Catheter lines can slip, so if the external line appears longer or shorter than it originally was, go see your infusion nurse and get it checked.  If you have symptoms of infection -- fever, chills or swelling -- report it to your doctor.  Blood infections must be treated promptly.  If you're trying to flush the catheter and it won't cooperate, don't try to force it.  The tube may be blocked or twisted, so call your clinic for professional help.

Continue Reading