Hickman Line – Hickman Catheter

What is a Hickman catheter?

A Hickman catheter is an in-dwelling intravenous catheter which is intended for long term use. It  is soft and flexible and normally has several lumens. It is tunnelled for a distance under the skin on the chest wall and inserted in a vein just above the collarbone and advanced to the largest vein in the body, adjacent to the heart. The Hickman line has a small cuff which is placed under the skin. This helps the line to be anchored in place and to provide a barrier against infection.

Hickman Line Insertion
Hickman catheter inserted by Dr Goh for patient prior to Stem Cell Transplantation.


When are Hickman Catheters used?

Hickman catheters are used for long term access into the venous system. Intravenous medications such as chemotherapy and antibiotics can be administered through the Hickman catheter. The Hickman catheter may be used to withdraw blood for analysis as well as administering blood products. They provide long term access to the patient’s venous system and reduce the need for constant needles and cannulas.

How are a Hickman lines inserted?

Prior to the procedure, the patient is given sedation and local anaesthetic.

I insert Hickman catheters utilising image guidance. The venous puncture is guided with an ultrasound machine. The catheter is then tunnelled and inserted into the venous system under X-ray guidance. The tip of the catheter requires to be precisely placed in the vascular system and this is confirmed with an angiogram. Sutures secure the catheter in place and are removed after a couple of days.