In the presence of contraindications to the placement of a PICC due to unavailability of the veins of the arm and/or to chronic renal insufficiency of grade 3b - 4 - 5, and/or to the presence of vascular, lymphatic, neuromuscular or osteoarticular pathologies in both arms, it will be necessary to implant a CICC (that is, by means of ultrasound-guided puncture and cannulation of a vein in the cervico-thoracic area or - more precisely - in the area above/below the clavicle).
Temporary immobility of the arms for pharmacological effect (e.g. patients under sedative/muscle relaxants in intensive care) or the presence of acute renal failure (another frequent occurrence in intensive care) do not constitute a contraindication to PICC insertion. States of severe coagulation alteration do not constitute a contraindication to PICCs. There is no specific contraindication to the use of PICC in the patient in intensive care, not even in the onco-hematologic patient: indeed, in these types of patients the PICC sometimes has a specific indication compared to the CICC, for example for the presence of tracheostomy or a state of anticoagulation.