Our vascular access team uses a stiff radiology wire with PICC insertions. The reasoning is that it is ok because the wire is never advanced past the tip of the PICC but just used to help advance the catheter. Some on the team also use the wire for changes outs similar to an IR insertion ie. cutting the catheter, inserting the rad wire, removing the old catheter over the rad wire, and then inserting the new catheter over the rad wire. I looked through INS standards but didn't see anything against this practice. Have felt uncomfortable about this practice and know that it would really cause controversy in our team if they had to change. What is the evidence and best practice concerning this?