The evaluation of correct picc positioning in radiological imaging of the chest

Abstract

Central venous catheterization (CVC) represents a very common procedure in medical practice. In fact, the CVC is used for central venous pressure measurement, fluid administration, chemotherapy, parenteral nutrition, and extracorporeal therapies. In literature, the ideal placement of CVCs is the atrial cavo junction, in the distal 1/3 of the superior vena cava, or
in the proximal 1/3 of the right atrium. The Peripherally Inserted Central Catheter (PICC) is a 40-60 cm long peripherally inserted central venous catheter with an average length of stay of more than 30 days. It is a medium- to long-term central venous device that allows for safer infusion of prolonged and/or intermittent therapies with drugs that would otherwise be injurious or toxic to small-caliber veins. International guidelines recommend always checking the correct placement of the CVC tip and identifying possible complications before its use. Chest radiography  represents in clinical practice the most widely used technique for checking CVC placement in the veins of the upper caval district and possible early complications related to placement.