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"We describe the placement technique of femoral tunnelled PICC in a patient with SVC syndrome" Naik et al (2022).
Femoral tunnelled PICC

Extract:

“Peripherally inserted central catheters (PICCs) are long-term vascular access devices commonly used for delivering chemotherapy, antibiotics or parenteral nutrition. PICCs are placed under ultrasound guidance in deep arm veins and the tip is placed in the lower third of the superior vena cava (SVC).[1] In SVC obstruction syndrome, the upper extremity is best avoided for vascular access due to raised venous pressures.[2] We describe the placement technique of femoral tunnelled PICC in a patient with SVC syndrome.”

Reference:

Naik VM, Cheruku DR, Swathi U, Rayani BK. Femoral peripherally inserted central catheter in superior vena cava syndrome – Challenges of tunnelling. Indian J Anaesth. 2022 May;66(5):388-389. doi: 10.4103/ija.ija_476_21. Epub 2022 May 19. PMID: 35782665; PMCID: PMC9241194.