How a Tunneled Central Line (CVC) Is Used

A tunneled central line is a long-term solution to the problem of accessing a person’s bloodstream. The tube, or catheter, that is inserted—typically beneath the skin of the chest—may provide access to the bloodstream for weeks, or even months. Usually, the placement of the catheter is done through an outpatient procedure. For some people, a tunneled central line may stay in place for the entire duration of cancer treatment, giving the medical team direct access to the bloodstream—whether it’s to administer chemotherapy, give blood products, or draw blood for tests—all without having to endure a needle stick each and every time the need arises. Caveat: children having a tunneled central line placed should not be told that this procedure means "no more needle sticks" in the future.


Central Line vs. Tunneled Central Line

Young man receiving a non-tunneled central venous catheter.
Joos Mind/Stone/Getty Images

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.



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.

2 Sources
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  1. Galloway M. Insertion and placement of central catheters in the oncology patient. Semin Oncol Nurs. 2010;26(2):102-12. doi:10.1016/j.soncn.2010.02.004

  2. Parienti JJ, Mongardon N, Mégarbane B, et al. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med. 2015;373(13):1220-9. doi:10.1056/NEJMoa1500964

Additional Reading
  • Funaki B. Tunneled Central Venous Catheter Insertion. Seminars in Interventional Radiology. 2008;25(4):432-436.
  • Goodman, M. Chemotherapy: Principles of Administration. In Yarbro, C., Frogge, M., Goodman, M., Groenwald, S. eds(2000) Cancer Nursing: Principles and Practice 5th ed American Cancer Society, Jones and Bartlett: Sudbury, MA.
  • Patient Education – Wexner Medical Center. Accessed December 2015.

By Karen Raymaakers
Karen Raymaakers RN, CON(C) is a certified oncology nurse that has worked with leukemia and lymphoma patients for over a decade.