How a Tunneled Central Line (CVC) Is Used

Central Line vs. Tunneled Central Line

Tunneled central lines are a special kind of central line, or central venous catheter (CVC). To use a plumbing analogy, all central lines give doctors access to the major blood vessels of the body—or the large access pipes beneath the streets. However, there is a difference between tapping into a fire hydrant during an emergency and installing a new spigot in a home, anticipating the need for continued access. Tunneled central lines are roughly equivalent to installing a temporary spigot at home. The idea is to keep the plumbing secure and to plan the path of the duct work beneath the skin, to avoid complications such as infection.

The tip of the CVC is located in a large vein near your heart. Tunneled CVCs are typically inserted into an incision in the chest, tunneled through the soft tissue beneath the skin, and then threaded into a large vein in your neck, and advanced closer to the heart. This "tunnel" under the skin helps to hold the catheter in place and prevent infection. There are a number of benefits with tunneled catheters, but there are also a number of important restrictions and precautions to be aware of, such as care of the site in the 48 hours after placement.

Also, from a patient's perspective, the particular manufacturer and/or name of the catheter system being used can be important—the medical team may even refer to the device by its "hospital name," so patients may benefit by becoming familiar with these terms, as appropriate, even if the reference is to a particular manufacturer.

Placement

Modern placement of a central venous catheter is associated with a number of improvements compared to in years past; the rate of all procedure-related complications has dropped dramatically with the use of imaging to guide the insertion of the catheter. Nevertheless, like all such procedures, central venous access is not without its risks.