PIC Port Placement

Background and indications

A PIC Port (Peripherally Implanted Central Port) is a central venous access device implanted under the arm skin, connected to a catheter with its tip in the superior vena cava. It combines PICC Line advantages (peripheral arm insertion, no pneumothorax risk) with port-a-cath benefits (subcutaneous implantable chamber, no daily maintenance, discretion).

Indications are identical to conventional port-a-cath: scheduled chemotherapy, prolonged intermittent venous access, and patients requiring long-term central access. PIC Port is preferred when cervical access is contraindicated or unwanted.

Pre-procedure assessment

Assessment includes arm venous Doppler ultrasound, coagulation panel, and CBC. Absence of venous thrombosis along the pathway is verified.

Procedure

Under local anesthesia and ultrasound guidance, the basilic or brachial vein is punctured at the arm. The catheter is advanced under fluoroscopy. A small subcutaneous pocket is created on the arm to implant the chamber. The device is sutured in place and the wound closed. Position verified by fluoroscopy. The procedure takes 30 to 45 minutes.

Results and scientific evidence

PIC Port offers 95-100% technical success rate with complication rates similar to conventional thoracic port-a-cath. The main advantage is the absence of pneumothorax risk and the arm scar rather than chest (cosmetic benefit).

Risks and complications

Venous thrombosis (5-10%), chamber infection (2-5% over total duration), catheter occlusion (5-8%), secondary displacement (< 3%). Absence of pneumothorax is a significant advantage over conventional port-a-cath.

Recovery

The chamber is usable after healing (5-7 days) or immediately if needed. No maintenance between uses (monthly flush if unused). Removal under local anesthesia in clinic.

Practical information

The procedure is performed as an outpatient or short inpatient stay depending on the case. It is performed by an interventional radiologist.