A tunneled CVC secured with a subcutaneously anchored system (SAS) can be used as long-term venous access. In most cases, the SAS will remain in place for many months, until the catheter is removed.
In the pediatric patient, a device of this type has the great advantage of allowing an easy removal that does not include either sedation or local anesthesia (as opposed to what necessary for removal of a cuffed catheter).
We recommend to use power injectable catheter, in latest-generation polyurethane, open ended, non-valved. This type of catheter is associated with minimal risk of rupture or mechanical complications, and lower risk of malfunction. For this purpose, we recommend the off-label use of catheters marketed as PICCs, which have the advantage of considerable length (50 cm and more) and insertion with modified Seldinger technique (which simplifies the tunneling maneuver).