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 I don't recall ever seeing anything like this in the literature, although it could be there in some study. We are beginning to see studies comparing outcomes with PICCs and other nontunneled CVADs, so it is possible that there is some type of statement to that effect in the literature. My experience does not validate this though. I can remember numerous patients where we placed multiple PICCs in the same vein. This was primarily osteomyelitis patients that kept returning with infection. Given this anecdotal information, I have serous doubts that 15% of PICC would render the vein no longer useful for anything! I would expert this doc to provide his evidence, especially if he is trying to get you to alter practice in some way. lynn

I would agree with Lynn....I have placed multi PICC in same patient over there course of treatment over the years and have not seen this to be the case.  Please share if the source is relealed to you.

Mark

In my experience, the ability to reuse a vein multiple times seems to be variable from patient to patient.  I have used the same vein for the purpose of vesicant chemo injection multiple times in some patients but in others the vein used is not longer viable.   I have placed multiple PICCs/midlines in the same vein(s) in some patients but in others the vein was too damaged to use again after the first PICC.  It seems the primary damage is to the vein in the periphery...at least initally.  So yes, I have assessed veins that have had PICCs in them (and LOS does not seem to factor in) that are no longer patent.  I have no reference for any percentage but I think 15% is a reasonable number and in fact, in my experience, may be higher.  My patient population (peds and infants) may factor in, but I am always reminded that each patient is different including their capacity (or the capacity of their veins) for multiple lines.

We have a pt that has RSD of his left arm from an old injury. He has had 7 PICC lines in the same vein in his right arm with out difficulty. We have another pt that had a PICC line in 8 years ago for TPN. He is now a dialysis pt and has a dialysis fistula in the same vein that he had the PICC in.

Personally- I had an IV in my left lower forearm cephalic ONCE, received one dose of KCL, developed phlebitis and now the cephalic vein is gone the entire length of my arm. Boy- I wish I had that vein back!

PICC nurses are getting much better at not putting catheters into vessels that are to small to accomadate them. I think we cause less vessel trauma then our surgeons and ED doctors.