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PICC tip at the axillary vein, is it safe to use?


We have a patient who has PICC where the tip lies in the axillary vein. Further distal, there is occlusion of the brachiocephalic vein from the extrinsic compression from the tumor. The physician reported that there seems to be cutaneous collaterals on the chest wall that bypass the SVCO through drainage via IVC.  Patient needs urgent chemo - 2 of the chemo are vesicant.  The physician stated that it is safe to administer the vesicant chemotherapy via the existing PICC and don't think it is necessary to insert femoral PICC.  Is this approach safe?  Appreciate your expert advice.  

Thank you 


No it is definitely not the

No it is definitely not the safest tip location and it is not the one supported by evidence and standards and guidelines. The tip in the axillary vein increases the risk of tip impinging on the vein wall, causing vein thronbosis and vessel erosion. I would refuse to use this for any infusion, especially vesicant chemotherapy. 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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