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Learn about femoral vein cannulation, how it is done, and when it is used
The femoral central line should be placed into the femoral vein, which is located in the upper thigh area. The catheter should be placed below the femoral ligament, in the middle of the thigh and avoiding the inguinal fold.
How is femoral vein cannulation done?
The procedure to place a femoral central line is as follows:
- You will have to lie down on your back for this procedure.
- Your physician will locate the femoral pulse with their nondominant hand.
- Local anesthetic is used to numb the insertion site.
- Your groin area is cleaned and shaved.
- Your doctor will puncture your skin with a needle to gain access to the blood vessel.
- A syringe is inserted to introduce guidewire into the blood vessel. A guidewire is a device that guides the catheter into place during the catheterization. You may feel some pressure. If you feel pain, immediately inform your doctor.
- Ultrasound guidance is used to place the guidewire correctly and minimize injury.
- Once the guidewire is held in place, and the syringe is slowly removed.
- Finally, your physician will make a small cut on the skin through which the guidewire was passed and run several times through the groin to create a passage for the central venous assembly threaded over the guidewire.
What is femoral vein cannulation?
The femoral vein is the major vein located deep within the thigh. It carries blood from the lower legs to the heart through the femoral triangle, which is a depression between the thigh muscles, where the femoral vein runs next to the femoral artery.
The femoral artery is the major source of blood supply to the legs. Physicians may use the femoral vein for catheterization in emergency cases or when other routes are inaccessible. However, catheterization of the femoral vein can increase the risk of infection and thrombosis.
When is the femoral central line used for cannulation?
Although the femoral vein is used as a central line, there is an increased risk of infection and thrombosis, particularly in bedridden people.
A femoral central line is usually indicated in the following situations:
- Secured or long-term vein access for the treatment of certain chronic conditions
- Failure to access a peripheral vein or another vein
- Intravenous (IV) infusion of fluids and drugs for treating cardiac arrest
- IV infusion of concentrated or irritating fluids
- IV infusion of large volume fluids that cannot be administered through peripheral lines or other central venous systems
- Hemodialysis or plasmapheresis (a procedure to separate blood plasma from the blood)
- Placing a pacemaker through the veins or monitoring the pulmonary artery
- Placement of an inferior vena cava filter
- Need for central venous access in people having issues with the superior vena cava
When should the femoral central line be avoided for cannulation?
The femoral central line should be avoided in the following conditions:
- Trauma at or around the site
- Infection at the insertion site
- Thrombosis of the femoral vein
- Abnormal anatomy at the site
- History of previous catheterization of the intended vein
- Extreme obesity
- Presence of bleeding disorders
- Previous radiation therapy
- History of sclerosant injection
What are possible complications of femoral central line placement?
Possible complications of femoral central line placement include:
- Infection
- Blood clot in the leg
- Blood vessel injury
- Collection of blood outside the blood vessel
- Bleeding risks
- Blockage of blood vessels caused by air bubbles
- Catheter misplacement
- Nerve injury
- Perforation (hole) in the bowel or bladder (rare)
