A tunneled FICC with a dacron cuff can be used as long-term venous access, provided it has been well implanted (most important point: the cuff must be at more than 2 cm from the exit site).
The FICC can be inserted by ultrasound-guided puncture of the common or superficial femoral vein, and then tunneled or towards the abdomen (in walking patients) or towards the knee (in bedridden patients).
We should use power injectable cuffed catheters, in latest-generation polyurethane, open-ended, non-valved, and appropriately long. These catheters (PowerLine, ProLine, etc.) are associated with minimal risk of rupture, mechanical complications, or malfunction. They are available in various sizes (5Fr, 6Fr, etc.), both single and double lumen. The cuffed silicon CICC used in the past (cuffed Groshong, Hickman, Broviac, Leonard) are now obsolete and should be abandoned, since they do not have any advantage in terms of biocompatibility but they have many disadvantages (difficulty in securement, low flow, fragility, tendency to dislocation and to tip migration, greater incidence of lumen occlusion, difficulty with disobstruction, impossibility of use at high pressure).
The cuff becomes efficient for stabilization purposes only two to three weeks after implantation (i.e. only after development of adhesions between the cuff and the subcutaneous tissue); in this first period after implantation, the catheter must be temporarily stabilized with a sutureless system with skin adhesiveness (or even with a SAS).