[Multiple difficulties for central venous access required the distal femoral vein catheterization: a case report]

Area of Science:

• Vascular Access
• Medical Ultrasound
• Cardiovascular Surgery

Background:

• Central venous catheterization is crucial for managing patients post-cardiovascular surgery.
• Traditional landmark-based techniques for central venous access can be unreliable.
• Previous interventions and anatomical variations often complicate venous access.

Observation:

• A patient requiring re-catheterization after major cardiovascular surgery presented with multiple venous access difficulties.
• Venous thrombosis was noted in the right internal jugular vein due to prior catheterization.
• Anatomical anomaly of the left internal jugular vein and scarring in the right subclavian and femoral regions precluded standard approaches.

Findings:

• Distal femoral vein cannulation was successfully performed using real-time ultrasound guidance.
• Ultrasound visualization was essential for navigating the complex anatomy and achieving successful access.
• This approach provided a critical alternative when other central venous access sites were compromised.

Implications:

• Ultrasound-guided distal femoral vein cannulation is a valuable technique for complex central venous access.
• This method can be particularly beneficial in patients with a history of surgery or venous complications.
• It expands the options for safe and effective venous access in challenging clinical scenarios.