Hickman line

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A Hickman line is a long-term intravenous catheter placed in a big vein to give medicines, such as chemotherapy, and to draw blood for tests. Some lines are used for other procedures like apheresis, dialysis, or total parenteral nutrition (TPN). They stay in place for extended periods when long-term IV access is needed.

History in brief: Early long-term venous catheters appeared in 1968. Dr. John W. Broviac improved the design in 1973. Dr. Robert O. Hickman added subcutaneous tunneling and a cuff in 1979 to help prevent infection.

How it is placed: The procedure is done under local anesthesia, sometimes with light sedation, by a nephrologist, interventional radiologist, or surgeon. Two small cuts are made—one near a neck vein (like the jugular) and one on the chest wall. A tunnel is created under the skin between the cuts, and the catheter is threaded through the tunnel into the chest’s large vein near the heart. The exit point is on the chest. The end of the catheter is secured under the skin with a cuff and dressed to stay clean. Ultrasound and X-ray help guide placement.

Care and risks: Possible problems during placement include bleeding or a collapsed lung. Later risks can include blood clots or infection. To keep the line open, it must be flushed regularly with normal saline. Keeping the exit site clean is important, especially for cancer patients. Signs of trouble include fever, swelling, or bleeding at the exit site—seek medical help if these occur.