1. The most commonly used path for PICC
Vein through the upper arm, through the axillary vein, subclavian vein, and innominate vein to the superior vena cava. The reason is that the veins are straighter, the diameter of the tube is thicker, and the vein valves are less.
2. Advantages of PICC
(1) Reduce the pain caused by repeated venipuncture; (2) It has a long indwelling time, which can be up to 6 months to 1 year, which can meet the needs of patients with medium and long-term intravenous infusion treatment and chemotherapy; (3) Avoid Stimulant drugs and corrosive drugs damage the patient’s blood vessels and protect the patient’s peripheral venous blood vessels; (4) Compared with other venipuncture techniques (subclavian vein, internal jugular vein), it avoids complications, such as pneumothorax , Hemothorax, etc., reducing the incidence of infection; (5) It is convenient to carry and can meet the daily needs of patients. The stability is good, the liquid flow rate is not affected by the patient’s position, and it is convenient for the patient to move during the infusion.
3. The main points of preoperative ultrasound evaluation of PICC deep veins
PICC patients need to be evaluated the patency and variation of the deep veins of the upper extremities before surgery, mainly for whether the axillary vein, subclavian vein, innominate vein and superior vena cava are unobstructed, and whether there is thrombosis. If there is an old thrombus, the guide wire generally cannot Passed; at the same time evaluate the presence or absence of double superior vena cava and only the left superior vena cava.
4. The main points of PICC superficial vein evaluation
The superficial vein of PICC mainly evaluates the cephalic vein, the important vein and the median cubital vein, observing the course of the superficial vein, measuring the diameter of the lumen. Locate the body surface if necessary. The superficial veins with the shallowest distance from the skin and the widest tube diameter are selected. Under the same conditions, the veins are the priority. The precise evaluation before surgery is helpful for success for one time and avoid repeated puncture of the blood vessel wall.
5. Disadvantages of ultrasound-guided PICC examination
Part of the tubular structure in PICC is located in the innominate vein and superior vena cava. The position is deep. Affected by chest gas, the catheter is difficult to display clearly, and it is impossible to know whether there is mural thrombus and blood flow information around the catheter. For patients with superior vena cava obstruction, it is difficult for ultrasound to display the superior vena cava and cannot provide accurate information about its inner diameter.
