What are the three types of CVADs?: An essential guide

October 1, 2025 •

4 min read

Over 90% of hospitalized patients require intravenous infusion treatment, and for long-term or specific therapies, this often necessitates the use of a Central Venous Access Device (CVAD). So, what are the three types of CVADs? They are the peripherally inserted central catheter (PICC), the tunneled catheter, and the implanted port, each designed for different clinical needs and treatment durations.

Quick Summary

The three main types of CVADs are PICC lines, tunneled catheters, and implanted ports. They provide long-term intravenous access for medications, fluids, and blood products, bypassing the need for repeated needle sticks.

Key Points

Three main types: The three CVAD types are peripherally inserted central catheters (PICCs), tunneled catheters, and implanted ports.
Duration is key: PICC lines are for weeks to months of treatment, while tunneled catheters and implanted ports are better suited for long-term or permanent access.
Access method varies: PICC lines and tunneled catheters have external components, whereas implanted ports are completely under the skin and accessed via a needle stick.
Minimizing infection: Tunneled catheters feature a subcutaneous cuff that anchors the device and creates a barrier against infection.
Lifestyle choice: Implanted ports are preferred by many patients due to their discreet nature and fewer activity restrictions when not in use.
Care prevents complications: Proper care, including regular flushing and sterile dressing changes, is essential for all CVADs to prevent infection, occlusion, and other complications.

What is a Central Venous Access Device (CVAD)?

Central Venous Access Devices (CVADs), also known as central lines or central venous catheters (CVCs), are thin, flexible tubes inserted into large veins that lead to the heart. They are used for long-term or frequent medical treatments, such as chemotherapy, long-term antibiotics, IV nutrition, and frequent blood draws. The three primary types of CVADs—PICC lines, tunneled catheters, and implanted ports—are chosen based on the patient's treatment plan, expected duration of use, and lifestyle needs.

Peripherally Inserted Central Catheter (PICC)

Also known as a PICC line, a peripherally inserted central catheter is a thin tube inserted into a peripheral vein, typically in the upper arm, and threaded until the tip rests in a large vein near the heart. PICC lines are generally used for treatments lasting from a few weeks up to several months.

Insertion:

A healthcare professional inserts the PICC line in an outpatient setting or at the patient's bedside.
An ultrasound or other imaging technique is used to guide the catheter's placement.
The procedure is performed under local anesthesia to numb the insertion site.

Advantages of a PICC Line:

Less invasive insertion procedure compared to other CVADs.
Can be placed at the bedside.
Avoids the discomfort and vein damage associated with frequent peripheral IV insertions.

Considerations and Maintenance:

The external portion requires a sterile dressing, which must be kept clean and dry at all times.
Physical activity, especially strenuous movement of the arm, may be restricted to prevent dislodgement or damage.
The line must be flushed regularly to prevent clotting.

Tunneled Catheter

A tunneled catheter is designed for long-term or permanent use and requires a minor surgical procedure for placement. The catheter is inserted into a large vein, usually in the neck or chest, and then tunneled under the skin before exiting at a separate site on the chest. A small cuff is attached to the catheter within the tunnel, encouraging tissue to grow around it. This cuff helps anchor the device and acts as a barrier to prevent infection. Brand names often associated with these devices include Hickman®, Broviac®, and Groshong®.

Benefits of a Tunneled Catheter:

More secure than a PICC line due to the subcutaneous cuff.
Lower risk of certain infections than non-tunneled lines.
Allows for long-term intravenous therapy outside of a hospital setting.

Use and Care:

The external catheter has one or more openings (lumens) for administering fluids, medication, or for drawing blood.
Similar to PICC lines, the exit site requires regular sterile dressing changes and careful flushing.

Implanted Port

An implanted port, also called a port-a-cath or mediport, is a CVAD that is completely under the skin. It consists of a small, self-sealing plastic or metal disc (the port) with a flexible catheter attached. During a surgical procedure, the port is placed just under the skin on the chest or arm, with the catheter threaded into a large central vein.

Accessing the Port:

To access the port, a healthcare provider inserts a special non-coring needle through the skin and into the port's septum.
This allows for the infusion of medications, fluids, or blood products, or for blood draws.

Advantages of an Implanted Port:

Lower risk of infection compared to catheters with external components.
Minimal impact on daily activities; patients can swim and bathe normally when the port is not accessed.
Concealed discreetly under the skin.
Designed for long-term or permanent use.

Comparison of CVAD Types


Feature	PICC Line	Tunneled Catheter	Implanted Port
Insertion Site	Peripheral vein (usually upper arm)	Central vein (neck/chest), exits on chest	Subcutaneous pocket (chest or arm)
Duration of Use	Short-to-medium term (weeks to months)	Long-term (months to years)	Long-term (months to years)
Visibility	External tubing, visible on the arm	External tubing, visible on the chest	Entirely under the skin; discreet
Access Method	External tubing with caps	External tubing with caps	Special needle inserted through the skin
Invasiveness	Minimally invasive, often bedside	Requires minor surgical procedure	Requires minor surgical procedure

Common Risks and Care Practices

Regardless of the type, all CVADs carry certain risks and require careful maintenance. The most common complications include:

Infection: The most serious risk is a bloodstream infection, often caused by bacteria entering the catheter. Strict sterile technique during insertion and daily care is crucial for prevention.
Occlusion or Clotting: The catheter can become blocked by a blood clot or other debris. Regular flushing with saline or a heparin solution helps keep the line clear.
Mechanical Complications: During insertion or removal, there is a small risk of arterial puncture, bleeding, or pneumothorax (collapsed lung). Catheter migration or rupture is also possible.
Thrombosis: A blood clot can form in the vein around the catheter, sometimes without causing symptoms.

Conclusion

Choosing the right CVAD is a vital part of managing long-term intravenous therapy. Understanding what are the three types of CVADs—PICC lines, tunneled catheters, and implanted ports—helps patients and healthcare providers make informed decisions based on treatment duration, medication type, and lifestyle needs. While all CVADs require diligent care to prevent complications, the advantages of reliable vascular access often outweigh the risks, significantly improving the quality of life for patients undergoing prolonged treatment. As always, patients should discuss the options and associated risks with their healthcare team to determine the best choice for their specific situation.

For more detailed information on CVADs, refer to reliable medical resources such as the Mayo Clinic guide on PICC lines.

Frequently Asked Questions

A regular intravenous (IV) line is typically placed in a smaller, peripheral vein and is only for short-term use. A CVAD is a longer catheter inserted into a large central vein near the heart, allowing for long-term treatment, complex medications, and less frequent needle sticks.

PICC lines are typically used for a few weeks to several months. Tunneled catheters and implanted ports are designed for longer-term use, lasting for months or even years, as determined by the patient's treatment needs.

Implanted ports are placed during a minor surgical procedure, typically with local anesthesia or sedation, so the patient does not feel pain during insertion. Afterward, there may be some soreness, but accessing the port for treatment can be made less uncomfortable with numbing cream.

Signs of a CVAD infection include redness, swelling, or pain at the insertion or exit site, as well as fever, chills, or drainage from the area. Any of these symptoms should be reported to a healthcare provider immediately.

Patients with external CVADs like PICC lines or tunneled catheters must keep the site clean and dry during bathing. Waterproof covers can be used for showering, but submersion (swimming, hot tubs) is often restricted. With an implanted port, swimming is generally allowed once the insertion site has healed and the port is not currently accessed with a needle.

The removal process depends on the type of CVAD. A PICC line can typically be removed at the bedside by a trained healthcare provider with a gentle pull. Tunneled catheters and implanted ports require a minor surgical procedure to remove the device.

A CVAD allows for blood draws without a separate needle stick. The nurse can draw blood directly from one of the catheter's lumens after flushing the line, making the process more convenient for patients needing frequent blood tests.

If a CVAD becomes blocked, it can prevent the delivery of medication. Healthcare providers can sometimes unclog the line with specific medication, but a severely blocked or damaged catheter may need to be removed and replaced.