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Central Venous Access
 
PICC LINES
      These are peripherally inserted central venous catheters which are introduced through an arm vein. The procedures is performed under local anesthesia with ultrasound and x-ray guidance and typically takes 10-15 minutes. The line is indicated for short term access typically less than 4-6 weeks duration.
 
TUNNELLED POWER LINE
     
Powerline is essentially a PICC line with a dacron cuff which helps to retain the line for a longer furation of time. The line is typically introduced through a tunnel created under the anterior chest wall skin and is then introduced into the jugular vein in the neck. The line is placed when more than 4-6 weeks of access is required, like for long term antibiotics. This type of line can be used for months if appropriate care is taken. The procedure is performed under conscious sedation and local anesthesia and takes 15-20 minutes. Ultrasound and x-ray guidance is used to ensure proper positioning.
 
PORT A CATH PLACEMENT
     Subcuatenous implantable ports are devices that have a reservoir which is introduced under the skin and can be accessed with a special needle (huber needle) for upto 2000 times. thus the device can be used for years. this device  is typically introduced in cancer patients who need chemotherapy and  intermittent venous access for months. the procedure is done under consciuos sedation and local anesthesia and takes 45-60 minutes. ultrasound and x ray guidance is used to ensure proper placement.
 
TUNELLED DIALYSIS CATHETER
     These catheters are used for patients with chronic renal failure who are on long term hemodialysis. they are introduced from under the anterior chest wall into the jugular vein. the catheter can be used for months unlike a temporary dialysis catheter. the procedure is performed under conscious sedation and local anesthesia with ultrasound and x ray guidance and takes 30-45 minutes.