In the case of short chemotherapy, or temporary home parenteral nutrition, or where there is an indication for infusion of solutions that are not compatible with the peripheral route, it is advisable to insert a medium term central venous access.
Although there is no consensus on the definition of the medium term, in most situations it is now understood that this is a period of around 4-6 months, to be interpreted flexibly.
Medium-term central VAD used in the pediatric patient include PICCs (non-tunneled or tunneled), tunneled CICCs and tunneled FICCs. In the past, a non-tunneled silicone CICC (Hohn catheter) had also been included in this category, but this device has now fallen into disuse because it is characterized by a high risk of accidental dislocation and breakage, linked to the fragility and morbidity of the material.
The choice between PICCs, tunneled CICCs and tunneled FICCs is based on the availability of the child's venous heritage.