A tunneled CICC can be inserted by ultrasound-guided cannulation of supra-clavicular veins (internal jugular, subclavian, or brachio-cephalic vein) or of infra-clavicular veins (axillary vein); it will be always tunneled towards the infra-clavicular area. A tunneled CICC secured to the skn with a subcutaneously anchored system (SAS) can be considered as a long-term central VAD. In most cases, the SAS will remain in place for many months, until the catheter is removed.
The catheter must be power injectable, in latest generation polyurethane, open-ended, non-valved. Catheters of this type are associated with minimal risk of malfunction and mechanical complications.