(See "Classification of lower extremity chronic venous disorders", section on 'Anatomy (The "A" component of CEAP)'.)įemoral artery pulsation provides a useful landmark to guide cannulation site selection ( picture 1). Lower extremity venous anatomy is discussed in detail separately. These veins can be inadvertently cannulated during the procedure and initially misinterpreted as femoral vein cannulation. The common femoral vein receives several tributaries within this region, including the great saphenous and anterior saphenous veins ( figure 2). Within the femoral triangle, the common femoral vein is enclosed within the femoral sheath, where it lies medial to the femoral artery. The hip joint and psoas muscle lie directly deep to the femoral neurovascular bundle at the level of the inguinal ligament. The vessel traverses the thigh and takes a superficial course at the femoral triangle before passing beneath the inguinal ligament into the pelvis as the external iliac vein ( figure 1A-B). (See "Central venous access in adults: General principles" and "Central venous catheters: Overview of complications and prevention in adults" and "Placement of jugular venous catheters" and "Placement of subclavian venous catheters".)įEMORAL VEIN ANATOMY - The femoral vein is the major deep vein of the lower extremity. Other considerations, complications of venous access, and issues related to other access sites are discussed elsewhere. Once a femoral access site has been selected as the best appropriate site, this topic guides the placement. (See "Central venous access: Device and site selection in adults" and "Central venous access in adults: General principles", section on 'Device and site selection'.) The initial selection of central venous access site and type of device are reviewed separately. Femoral venous access also facilitates introduction of venous devices (eg, inferior vena cava filter, pulmonary artery catheter, extracorporeal membrane oxygenation cannula, iliac venous stent). This access site is often preferred for temporary hemodialysis access. Although femoral vein cannulation is often considered less desirable due to higher complication rates, the femoral veins remain a reliable central venous access site, particularly under urgent or emergency circumstances. INTRODUCTION - Central catheters provide dependable intravenous access and enable hemodynamic monitoring and blood sampling.
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