title: [Multiple difficulties for central venous access required the distal femoral vein catheterization: a case report].
abstract: The low femoral approach for catheterization of the central venous line is a difficult procedure because the surface landmark technique is not helpful. We report a case of patient who required the distal femoral cannulation. Re-catheter cannulation was planned for the patient after the major cardiovascular surgery. The right internal jugular vein showed the venous thrombus attributed to the previous catheter placement for the operation. The left internal, jugular vein had anatomical anomaly at the level of cricoid cartilage and the last approach for cannulation was not feasible. The right subclavian and right femoral regions were scarred with the surgical procedure. Finally, we performed the distal femoral cannulation using real time ultrasound guidance. When multiple difficulties for venous access are present, ultrasound-guided low approach of femoral vein might be one of the solutions.
authors.affiliation: Intensive Care Unit of University Hospital, Hamamatsu University School of Medicine, Hamamatsu 431-3192.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Adachi
authors.forename: Taiga
authors.initials: T
authors.lastname: Itagaki
authors.forename: Katsumi
authors.initials: K
authors.lastname: Suzuki
authors.forename: Sakiko
authors.initials: S
authors.lastname: Uchisaki
authors.forename: Kaori
authors.initials: K
authors.lastname: Kimura
authors.forename: Yukako
authors.initials: Y
authors.lastname: Obata
authors.forename: Matsuyuki
authors.initials: M
authors.lastname: Doi
authors.forename: Shigehito
authors.initials: S
authors.lastname: Sato
mesh_terms: D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D013504:Cardiovascular Surgical Procedures; D002405:Catheterization, Central Venous / Q000379:methods*; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D018084:Ultrasonography, Interventional / Q000379:methods