What Are the Three Basic Types of Central Venous Catheters?

October 1, 2025 •

4 min read

Central venous catheterization is a common procedure, with over 5 million performed annually in the U.S. alone. For those undergoing long-term treatments, understanding what are the three basic types of central venous catheters is essential for grasping the nature of their medical care.

Quick Summary

The three primary types of central venous catheters (CVCs) are peripherally inserted central catheters (PICCs), tunneled catheters, and implanted ports. These devices provide various forms of long-term intravenous access for delivering medications, fluids, and nutrition.

Key Points

PICCs: Peripherally Inserted Central Catheters are inserted in an arm vein and used for intermediate-term intravenous therapy, typically lasting weeks to months.
Tunneled Catheters: These are surgically placed under the skin and into a central vein, featuring a cuff that helps prevent infection and stabilize the catheter for long-term use (months to years).
Implanted Ports: These devices are placed entirely under the skin, offering a discreet option with the lowest infection risk, suitable for long-term treatment.
Device Selection Factors: The choice of CVC depends on the expected duration of treatment, patient lifestyle, and risk factors, with ports generally preferred for very long-term use.
Risk and Care: All CVC types require sterile maintenance to prevent complications such as infection, blood clots, and blockages, with training provided to patients and caregivers.
Common Access Points: Insertion can occur in veins in the neck, chest, or arm, depending on the catheter type chosen and the patient's anatomy.

A central venous catheter (CVC), also known as a central line, is a thin, flexible tube inserted into a large vein, typically in the neck, chest, or arm, with the tip resting near the heart. CVCs provide direct access to the bloodstream for long-term treatments that would otherwise damage smaller, peripheral veins. While short-term, non-tunneled catheters are available for emergency or acute situations, the three basic and most common types for intermediate to long-term use are peripherally inserted central catheters (PICCs), tunneled central venous catheters, and implanted ports. The choice depends on the anticipated duration of therapy, the patient's lifestyle, and clinical factors.

Peripherally Inserted Central Catheter (PICC)

A Peripherally Inserted Central Catheter, or PICC line, is a long-term CVC that is typically inserted into a vein in the upper arm. The catheter is then threaded through the veins until its tip sits in the superior vena cava, a large vein near the heart.

Characteristics of a PICC

Insertion site: Usually placed in the basilic, cephalic, or brachial vein of the upper arm.
Duration of use: Designed for intermediate-term use, lasting from several weeks up to several months.
Insertion procedure: Often performed at the patient's bedside or in an interventional radiology suite with ultrasound guidance, reducing procedural risks.
Maintenance: Requires regular dressing changes and flushing to prevent blockage.

Tunneled Central Venous Catheter

A tunneled central venous catheter is designed for long-term use, lasting for many months or years. It gets its name from the way it is surgically threaded, or "tunneled," under the skin before it enters a large vein in the neck or chest. The catheter's external end emerges from the skin some distance from where it enters the vein.

Characteristics of a Tunneled Catheter

Insertion site: Surgically inserted into a large vein (e.g., jugular or subclavian) and tunneled beneath the skin of the chest.
Duration of use: Suited for long-term therapy, including months to years of use.
Examples: Well-known brand names include Hickman, Broviac, and Groshong catheters.
Infection control: The tissue ingrowth cuff on the tunneled portion helps stabilize the catheter and provides a barrier against infection.

Implanted Port

An implanted port, also called a Port-a-Cath, is a long-term CVC that is surgically placed entirely under the skin. It consists of a small, self-sealing reservoir (the port) connected to a catheter that is threaded into a large central vein.

Characteristics of an Implanted Port

Placement: Surgically implanted beneath the skin, typically in the chest.
Access: Accessed by a healthcare provider using a special non-coring needle that punctures the skin and port septum.
Duration of use: Can remain in place for years, offering the lowest risk of infection among long-term CVCs.
Appearance: Discreet, with no external tubing or dressing required when not in use.

Comparison of Central Venous Catheter Types


Feature	Peripherally Inserted Central Catheter (PICC)	Tunneled Catheter	Implanted Port
Insertion	Arm vein (e.g., basilic, cephalic)	Surgical placement in neck/chest, exits through skin on chest	Surgical placement entirely under the skin, usually chest
Duration	Weeks to months	Months to years	Months to years
Appearance	Visible tubing and dressing on the arm	Visible tubing and dressing on the chest	Not visible when unaccessed; accessed by a needle through the skin
Infection Risk	Moderate	Moderate to low	Lowest infection risk
Access Method	Needleless connector on external tubing	Needleless connector on external tubing	Non-coring needle to puncture skin and port
Patient Lifestyle	Requires careful management to avoid dislodgement; restricted water activities	Requires careful management to avoid dislodgement; can be cumbersome	Few activity restrictions; discreet and easy to conceal

Choosing the Right Catheter

Multiple factors are considered when a healthcare provider selects the appropriate CVC for a patient. The primary determinant is the expected duration of treatment. For example, a PICC line is often a suitable choice for someone needing several months of IV antibiotics. A tunneled catheter or implanted port is preferred for those with chronic conditions like cancer, requiring long-term chemotherapy. Patient preference, the condition of peripheral veins, and the availability of resources for insertion also play a role. Implanted ports offer the lowest infection risk and improved quality of life due to their discreet nature.

Managing Your CVC: Care and Potential Complications

Proper care is critical for preventing complications associated with all CVC types. This involves following strict sterile procedures for flushing the catheter and changing dressings to reduce the risk of infection.

Potential Complications

Infection: A serious risk, as bacteria can enter the bloodstream through the catheter. The lowest infection risk is with implanted ports.
Blood clots: Formation of a clot (thrombosis) around the catheter tip can block the device or lead to more serious issues like deep vein thrombosis.
Catheter blockage: Fibrin or clot buildup can obstruct the catheter, preventing infusions or blood draws.
Mechanical issues: Problems can include catheter fracture, dislodgement, or pinch-off syndrome, especially with subclavian lines.

Healthcare teams work with patients to manage these risks. Training on proper flushing techniques and recognizing signs of infection is a key part of CVC care for patients and caregivers.

Conclusion

Central venous catheters are indispensable medical devices that offer reliable, long-term access to a patient's central circulation. While there are several types, the three basic and most common options are PICCs, tunneled catheters, and implanted ports, each with distinct advantages and use-cases. The choice among them depends on the planned duration of therapy, the patient's condition, and other clinical considerations. By understanding the differences, patients and their caregivers can feel more confident and informed about their treatment plan. For more information, patients should consult their healthcare provider and can find valuable resources on health portals like the Cleveland Clinic.

Visit the Cleveland Clinic's page on Central Venous Catheters for more details

Frequently Asked Questions

A PICC line is typically used for intermediate-term intravenous access, and it can remain in place for several weeks to several months.

The main advantages of an implanted port are its discreet placement entirely under the skin and the low risk of infection, making it ideal for long-term therapy.

A tunneled catheter is surgically placed with an exit site on the chest, while a PICC line is inserted into a vein in the arm. Tunneled catheters are often used for longer-term therapy (months to years) compared to PICCs (weeks to months).

The insertion of a CVC is typically done with local anesthesia and sometimes light sedation, so discomfort during the procedure is minimized. Pain after the procedure is manageable with medication.

The most common complications include infection, blood clots, and catheter blockage. The risk varies depending on the type of catheter and its duration of use.

Proper care includes keeping the area clean and dry, performing regular sterile dressing changes, and flushing the line as instructed by your healthcare team to prevent infection and blockage.

Implanted ports, because they are entirely under the skin and are only accessed when needed, have the lowest risk of infection among the central venous catheters.