I sometimes receive requests to place a PICC to the opposite arm after a (occlusive and non-occlusive) DVT has been confirmed by US. While I feel that placing another PICC to the opposite arm has a high liklehood of developing a clot, we sometimes do it (based on other options and the risk vs. benefits evaluation). My concern is more for the patient who has developed extensive, occlusive DVT that extends beyond the axilla and into the subclavian region on that side. My concern is if I place a PICC on the opposite side, even though the new PICC doesn't go there, will it be close enough to cause further thrombus that would extend further into the vasculature despite placing a patient on therapeutic doses of anticoagulants? Any thoughts on this would be appreciated.