A tunneled cuffed PICC is appropriate as long-term central VAD, provided that it adequately inserted (important point: the cuff must be inside the tunnel, at least 2 cm or more from the exit site of the catheter).
Cuffed PICC in polyurethane, power injectable, open-ended, non-valved, are currently available. This type of catheters will be associated with minimal risk of
malfunction and mechanical complications. They are available in various sizes (5Fr, 6Fr, etc.), both single and double lumen.
Interestingly, the cuff becomes efficient for stabilization purposes only 2-3 weeks after implantation (i.e. only after the development of adhesions between the cuff and the subcutaneous tissue); therefore, in this first weeks after implantation, the catheter must be temporarily stabilized with a sutureless system with skin adhesiveness (or even with a SAS, as recently described in the literature).