Peripherally placed PICC line. The arm was prepped and draped in sterile fashion. Lidocaine 1% was used for local anesthetic. Under fluoroscopic and ultrasound guidance, the vein was patent and accessed with a micropuncture needle. A guide wire was then advanced into the vein. A vascular sheath was then advanced over a guide wire, and a PICC line was trimmed. The PICC line was then advanced into the central venous system. After confirmation of the catheter position, the catheter was sutured in place at the skin entry site.