Ultrasound-Guided Femoral Vein Catheterization

Aka: Ultrasound-Guided Femoral Vein Catheterization, Femoral Line, Femoral Central Line, Femoral Vein Catheterization, Catheterization of Common Femoral Vein

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II. Indications

  1. See Central IV Access

III. Contraindications

  1. See Central IV Access

IV. Adverse Effects

  1. See Central IV Access

V. Preparation

  1. Anatomy
    1. Neurovascular bundle lies at the medial one third between
      1. Anterior superior iliac spine (ASIS)
      2. Pubic tubercle or Symphysis Pubis
    2. From Lateral to Medial (Mnemonic: NAVEL)
      1. Nerve
      2. Artery
      3. Vein
      4. Empty Space
      5. Lymph Nodes
  2. Patient positioning
    1. Patient supine
    2. Ipsilateral leg is slightly abducted and externally rotated (toes pointed laterally)
    3. Assistant may be needed to retract abdominal wall pannus that obscures inguinal region

VI. Technique: Landmark-Based Entry

  1. External landmarks
    1. Neurovascular bundle is at the medial third between the ASIS and Symphysis Pubis
    2. Palpate femoral pulse (femoral vein is medial to artery)
  2. Entry site
    1. Needle insertion should be inferior to inguinal ligament
      1. Vessels are noncompressible superior to the inguinal ligament (Hemorrhage risk)
    2. Insert needle at 1 cm medial to femoral pulse
    3. Needle directed cephalad (and slightly medial) at 30-45 degree angle

VII. References

  1. Rutherford (2025) Anatomy of Central Venous Access, Hospital Procedures Course, attended 9/12/2025

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