I was consulted to ED to start a 18 g angio in a.c. for a CTPA.Â I was unsuccessful. A picc was then ordered. I went back & had my sterile field all set up, when angio dept came in & said pt didnt need a picc. It's a long story I wont go into it. Â Pt already had a 22 g angio in her other a.c.. Angio dept was going to exchange her 22g for a 18 g with a wire. I assume this would be the same as a picc over the wire exchange. Is this standard practice? Does anyone else do this? Any contraindications to it? Is the 18 g angio catheter strong enough to slide into the skin?Â I'm wondering if I should have done this instead of a picc? I had offered to place a midline.