![]() We use the Seldinger technique to channel the femoral vein and place the catheter.The following complications may arise in the femoral vein approach: The femoral vein is situated medially to the femoral artery and is channelled at 1-1.5 cm medial to the place where the pulse is felt and 2-3 cm below the inguinal ligament ( figure 2). ![]() The femoral artery is located by feeling its pulse at the union of the middle third and two side thirds of the inguinal ligament ( figure 1). The patient is firstly placed in supine position with the lower extremity in abduction and external rotation. ![]() The patient must be placed correctly and a precise anatomical knowledge of the puncture area is essential in femoral approach. The asepsis measures recommended for all central catheters must be used (sterile field, surgical hand wash, mask, gown and sterile gloves). The catheter to be used must be longer than 20 cm (the most commonly used measures 24 cm), and in the majority of the cases, it will have to be dual-lumen. There are very few counter-indications for the femoral catheter: active infection in the skin of the femoral area, and thrombosis of the inferior vena cava, iliac artery or femoral artery. It is considered that the femoral catheter must not be maintained for more than one week because the risk of infection is high due to its location. This access is also indicated in patients who immediately require light chains in the myeloma in the plasmapheresis or in the dialysis. ![]() The placement of a femoral catheter is, therefore, adequate in situations of acute renal insufficiency that require continuous or intermittent haemodialysis techniques, or in patients with chronic renal insufficiency without vascular access (failure of the fistula, transplanted patients or with peritoneal dialysis) in critical situation. The placement of a femoral catheter for haemodialysis is indicated when there is an urgent and temporary need for treatment, when other approaches cannot be used (for example jugular catheter), when no radiological control is available, or when the patient's situation means that he or she cannot be placed in prone position (for example, patients with acute lung oedema or with a compromised thoracic situation). Vascular access with femoral catheter is one of the most commonly used temporary accesses in haemodialysis. ![]()
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