Skin related problems around the insertion site (infection, phlebitis, scars)

History of mastectomy/axillary dissection on insertion side

Coagulopathy with an INR of \> 2.0

Thrombocytopenia with platelets \< 25,000 uL

Renal insufficiency with a creatinine of \> 3.0 mg/dL

Documented current upper extremity or central venous thrombosis

Hypercoagulable states (protein C or S deficiency, AT-III deficiency, lupus anticoagulant)

Catheters needed for therapy within less than an hour (emergent placement not allowing sufficient time for proper research consent and randomization)

Patient has already been enrolled in this research study

Life expectancy less than 1 month

Peripherally Inserted Central Catheter (PICC) Thrombosis: Reverse Taper Versus Non-tapered Catheters