Femoral Central Venous Access Questions & Answers

1. Moraco AH, Kopec SE. Central venous catheters. Irwin RS, Lilly CM, Mayo PH, Rippe JM, eds. Irwin & Rippe's Intensive Care Medicine. 8th ed. Philadelphia: Wolters Kluwer; 2018. 36-49.

2. Santos FKY, Flumignan RLG, Areias LL, Sarpe AKP, Amaral FCF, Ávila RB, et al. Peripherally inserted central catheter versus central venous catheter for intravenous access: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020 Jul 24. 99 (30):e20352. [QxMD MEDLINE Link].

3. Marik PE, Flemmer M, Harrison W. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis. Crit Care Med. 2012 Aug. 40 (8):2479-85. [QxMD MEDLINE Link].

4. [Guideline] American Society of Anesthesiologists Task Force on Central Venous Access., Rupp SM, Apfelbaum JL, Blitt C, Caplan RA, Connis RT, et al. Practice guidelines for central venous access: a report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology. 2012 Mar. 116 (3):539-73. [QxMD MEDLINE Link].

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6. [Guideline] Bodenham Chair A, Babu S, Bennett J, Binks R, Fee P, Fox B, et al. Association of Anaesthetists of Great Britain and Ireland: Safe vascular access 2016. Anaesthesia. 2016 May. 71 (5):573-85. [QxMD MEDLINE Link]. [Full Text].

7. Pikwer A, Sterner G, Acosta S. Inadvertent arterial catheterization complicating femoral venous access for haemodialysis. Scand J Urol Nephrol. 2012 Apr. 46 (2):156-60. [QxMD MEDLINE Link].

8. Parienti JJ, Thirion M, Mégarbane B, Souweine B, Ouchikhe A, Polito A, et al. Femoral vs jugular venous catheterization and risk of nosocomial events in adults requiring acute renal replacement therapy: a randomized controlled trial. JAMA. 2008 May 28. 299 (20):2413-22. [QxMD MEDLINE Link].

9. Gallieni M, Pittiruti M, Biffi R. Vascular access in oncology patients. CA Cancer J Clin. 2008 Nov-Dec. 58 (6):323-46. [QxMD MEDLINE Link].

10. Deshpande KS, Hatem C, Ulrich HL, Currie BP, Aldrich TK, Bryan-Brown CW, et al. The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population. Crit Care Med. 2005 Jan. 33 (1):13-20; discussion 234-5. [QxMD MEDLINE Link].

11. SELDINGER SI. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta Radiol. 1953 May. 39 (5):368-76. [QxMD MEDLINE Link].

12. Marino PL. Central venous access. Marino's The ICU Book. 4th ed. Philadelphia: Wolters Kluwer; 2014. 17-40.

13. Hoffman T, Du Plessis M, Prekupec MP, Gielecki J, Zurada A, Shane Tubbs R, et al. Ultrasound-guided central venous catheterization: A review of the relevant anatomy, technique, complications, and anatomical variations. Clin Anat. 2017 Mar. 30 (2):237-250. [QxMD MEDLINE Link].

14. Annetta MG, Marche B, Dolcetti L, Taraschi C, La Greca A, Musarò A, et al. Ultrasound-guided cannulation of the superficial femoral vein for central venous access. J Vasc Access. 2021 Mar 21. 11297298211003745. [QxMD MEDLINE Link].

15. Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev. 2015 Jan 9. 1:CD011447. [QxMD MEDLINE Link].

16. Franco-Sadud R, Schnobrich D, Mathews BK, Candotti C, Abdel-Ghani S, Perez MG, et al. Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2019 Sep 6. 14:E1-E22. [QxMD MEDLINE Link].

17. Horowitz R, Gossett JG, Bailitz J, Wax D, Pierce MC. The FLUSH study--flush the line and ultrasound the heart: ultrasonographic confirmation of central femoral venous line placement. Ann Emerg Med. 2014 Jun. 63 (6):678-83. [QxMD MEDLINE Link].

18. Abboud PA, Kendall JL. Ultrasound guidance for vascular access. Emerg Med Clin North Am. 2004 Aug. 22 (3):749-73. [QxMD MEDLINE Link].

19. Karapinar B, Cura A. Complications of central venous catheterization in critically ill children. Pediatr Int. 2007 Oct. 49 (5):593-9. [QxMD MEDLINE Link].

20. Eisen LA, Narasimhan M, Berger JS, Mayo PH, Rosen MJ, Schneider RF. Mechanical complications of central venous catheters. J Intensive Care Med. 2006 Jan-Feb. 21 (1):40-6. [QxMD MEDLINE Link]. [Full Text].

21. Sirvent AE, Enríquez R, Millán I, García-Marco JM, Rodríguez-Czaplicki E, Redondo-Pachón MD, et al. Severe hemorrhage because of delayed iliac vein rupture after dialysis catheter placement: is it preventable?. Hemodial Int. 2012 Apr. 16 (2):315-9. [QxMD MEDLINE Link].

22. Warkentine FH, Clyde Pierce M, Lorenz D, Kim IK. The anatomic relationship of femoral vein to femoral artery in euvolemic pediatric patients by ultrasonography: implications for pediatric femoral central venous access. Acad Emerg Med. 2008 May. 15 (5):426-30. [QxMD MEDLINE Link].

Neelu Pal, MD General Surgeon

Neelu Pal, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, Society of American Gastrointestinal and Endoscopic Surgeons

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

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Laurie Scudder, DNP, NP Nurse Planner, Medscape; Senior Clinical Professor of Nursing, George Washington University

Disclosure: Nothing to disclose.

Vincent Lopez Rowe, MD, FACS Professor and Chief, Division of Vascular and Endovascular Surgery, Gonda (Goldschmied) Vascular Center, University of California, Los Angeles, David Geffen School of Medicine

Vincent Lopez Rowe, MD, FACS is a member of the following medical societies: American College of Surgeons, American Heart Association, American Surgical Association, Pacific Coast Surgical Association, Society for Clinical Vascular Surgery, Society for Vascular Surgery, Society of Black Academic Surgeons, Society of Black Vascular Surgeons, Southern California Vascular Surgical Society, Western Vascular Society

Disclosure: Nothing to disclose.

Gil Z Shlamovitz, MD, FACEP Professor of Clinical Emergency Medicine, Keck School of Medicine of the University of Southern California; Chief Medical Information Officer, Keck Medicine of USC

Gil Z Shlamovitz, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

The authors and editors of Medscape Drugs & Diseases gratefully acknowledge the assistance of Lars Grimm, MD, MHS, with the literature review and referencing of this article.

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