The FICC can be inserted by ultrasound guided puncture of the common or superficial femoral vein and then tunneled towards the knee or towards the abdomen. In active and walking patients, this second option will be preferable.
A tunnelled FICC secured with a subcutaneously anchored system (SAS) can be regarede as a long-term venous access. In most cases, the SAS will remain in place for many months, until the catheter is removed.
The catheter must be power injectable, in latest-generation polyurethane, open-ended, non-valved. Such catheters are associated with minimal risk of rupture, mechanical complications, and malfunctions. For this purpose, we recommend the off-label use of catheters marketed as power injectable PICCs, since they have the advantage of considerable length (50 cm and more) and they can be insertion with modified Seldinger technique (which simplifies the tunneling maneuver).