Which veins are used for PICC line insertion?

• A. Basilic or cephalic veins
• B. Jugular veins
• C. Subclavian vein
• D. Femoral vein

Answer: (A)

A PICC line is placed by using a peripheral vein in the upper arm and threading the catheter into the central venous system, so the veins used are the basilic and cephalic veins. The basilic vein, on the medial side of the arm, is often larger and can provide a relatively straight path through the axillary to the central veins, making catheter advancement smoother and with fewer twists. If the basilic vein isn’t suitable, the cephalic vein on the lateral, more superficial side can be used as an alternative, though its route to the central circulation can be more tortuous.

The other options involve central veins accessed for different types of lines. Jugular and subclavian veins are central venous sites used for non-PICC central lines, and puncturing these carries different risks, such as pneumothorax and a higher infection profile. The femoral vein is another central site and is generally avoided for PICCs due to a higher infection risk and practicality concerns, especially in ambulatory or long-term use.