Cannulation of the superficial femoral vein at mid-thigh when catheterization of the superior vena cava system is contraindicated.

PURPOSE: Patients needing medium- to long-term infusion therapy with limited catheterization via the superior vena cava system is a challenging condition. The conventional catheterization via the femoral vein in the groin has a high complication rate, discomfort, and short indwelling time. Since changing the insertion site can avoid the disadvantage of conventional catheterization via the femoral vein in the groin, the present study aimed to investigate the effects of femoral inserted central catheters insertion via the superficial femoral vein at the mid-thigh to resolve the issue of limited superior vena cava system catheterization.

METHODS: Based on the symptoms and signs, enhanced computed tomography findings, and insertion history, in 121 patients, limited catheterization via the superior vena cava system was identified. Subsequently, the femoral inserted central catheters were inserted via the superficial femoral vein at the mid-thigh under the guidance of ultrasound, and the tip of femoral inserted central catheters was in the inferior vena cava.

RESULTS: A total of 121 patients underwent femoral inserted central catheters insertion via a superficial femoral vein at the mid-thigh from August 2017 to December 2018. The success rate of insertion was 100%, and the indwelling time was 3-472 days. The complications of femoral inserted central catheters in the thigh were similar to that of peripherally inserted central catheters in the arm. The incidence of primary malposition was 1.65%, the incidence of catheter-related thrombosis was 0.83%, and the central line associated bloodstream infection rate was 0.83%. Subsequently, 116 lines (95.87%) were removed at the end of the treatment, one line (0.83%) was accidentally removed by the patient, and four lines (3.31%) were unplanned removed due to complications.

CONCLUSION: The technique of femoral inserted central catheters insertion via the superficial femoral vein at the mid-thigh has a high success rate, low complication rate, and less impact on activities, and is easy to maintain. This phenomenon resolves the patient's needs of medium- to long-term infusion therapy with limited catheterization of superior vena cava system.