Femoral Catheter Size

Size Ranges by Catheter Type

The American College of Radiology recommends that nontunneled femoral catheters used for 1-3 weeks range from 5F to 14F in size for short-term central venous access, with selection based on intended use and patient factors 1
The American College of Radiology states that these catheters are typically 20-30 cm long and are designed for continuous short-term infusions, drug delivery, hemodialysis, apheresis, and cardiovascular pressure monitoring 2
For use up to 3 months, intermediate catheters such as PICCs range from 2F to 7F, according to the American College of Radiology 1
The American College of Radiology reports that Hohn catheters are available in single lumen 5F or dual lumen 7F 1
Tunneled femoral catheters for long-term use (>3 months) range from 3.5F to 21F, as recommended by the American College of Radiology 1

The American College of Radiology suggests using the smallest diameter catheter and minimum number of lumens necessary to minimize the risk of catheter-related complications 1, 2

For minimally invasive mitral valve surgery requiring femoral arterial cannulation, a 21F side-arm cannula is standard when femoral artery size permits, according to the guidelines 3
A 19F cannula can be used for smaller femoral arteries in minimally invasive mitral valve surgery, as reported 3

Most modern central venous catheters are made of silicone or polyurethane, which are associated with fewer infections than polyvinyl chloride or polyethylene, according to the American College of Radiology 1
Silicone is a soft biocompatible rubber that is one of the least thrombogenic materials, as stated by the American College of Radiology 1

The American College of Radiology recommends always selecting the smallest diameter catheter that will accomplish the clinical goal 1, 2
Consider duration of intended use when selecting catheter type and size, as suggested by the American College of Radiology 1
For high-flow applications, balance the need for adequate flow with the risk of complications from larger catheters, according to the American College of Radiology 1

The American College of Radiology suggests that femoral vein access already carries the highest infection risk compared to other central venous sites, with high rates of venous thrombosis, and should be avoided when other sites are available 4
The American Journal of Kidney Diseases recommends that transplant candidates should never have femoral catheters due to risk of iliac vein stenosis, which compromises the anastomosis site for kidney transplantation 5

For minimally invasive cardiac surgery requiring femoral venous cannulation for cardiopulmonary bypass, multistage femoral venous catheters are used, but even these are typically 15F to 18F 6, 7
For arterial cannulation in cardiac surgery, a 23F side-arm arterial cannula is standard when vessel size permits, with 21F used if arterial line pressure concerns exist, and 19F for smaller vessels 6, 8

A 27F catheter would likely occlude the femoral vein entirely, causing immediate venous obstruction and limb swelling 5
The Society for Vascular Surgery implies that femoral catheters should not remain in place >5 days for noncuffed catheters in bed-bound patients 5

For hemodialysis, the American Journal of Kidney Diseases suggests using catheters in the range appropriate for dialysis flow requirements (typically larger than standard CVCs but still <21F) 5
The American College of Radiology recommends confirming adequate catheter length, with femoral catheters needing to be at least 19cm long to reach the IVC and minimize recirculation 5