What is the typical size of a femoral catheter (Femoral Catheter, FC)?

Femoral Catheter Size

Femoral catheters typically range in size from 5F to 14F for short-term central venous access, with selection based on intended use and patient factors. 1

Size Ranges by Catheter Type

Short-term Femoral Catheters

• Nontunneled (temporary) femoral catheters used for 1-3 weeks range from 5F to 14F 1
• These catheters are typically 20-30 cm long and are designed for continuous short-term infusions, drug delivery, hemodialysis, apheresis, and cardiovascular pressure monitoring 1

Intermediate-term Catheters

• For use up to 3 months, intermediate catheters such as PICCs range from 2F to 7F 1
• Hohn catheters (another intermediate option) are available in single lumen 5F or dual lumen 7F 1

Long-term Catheters

• Tunneled femoral catheters for long-term use (>3 months) range from 3.5F to 21F 1
• For femorally inserted central catheters with exit site at mid-thigh, an average length of 47.6 ± 2.4 cm is reported, with recommendation for at least 50 cm long catheters 2

Size Selection Considerations

General Principle

• Use the smallest diameter catheter and minimum number of lumens necessary to minimize the risk of catheter-related complications 1

Patient-Specific Factors

• For pediatric patients, smaller catheters are essential:
  • 2.5F, 5-cm polyethylene catheters are associated with fewer complications in neonates and infants compared to larger catheters 3
  • Pulse loss occurred in 3.4% overall (6.7% in neonates, 1.4% in older infants) with small-bore catheters 3

Procedure-Specific Factors

• For cardiac catheterization, smaller sheaths (5F-8F) are commonly used in the femoral artery 4
• 6F guiding catheters for coronary angioplasty show fewer femoral complications (13.8%) compared to 7F/8F catheters (23.5%) 5
• For minimally invasive mitral valve surgery requiring femoral arterial cannulation:
  • 21F side-arm cannula is standard when femoral artery size permits 1
  • 19F cannula can be used for smaller femoral arteries 1

Complications Related to Catheter Size

Mechanical Complications

• Larger catheters increase risk of mechanical complications 1
• Duration of insertion is a significant risk factor for mechanical complications (OR 1.05 per additional minute) 6

Infectious Complications

• Femoral catheterization has higher infectious complication rates (19.8%) compared to subclavian sites (4.5%) 6
• Infection rates for femorally inserted central catheters with exit site at mid-thigh are reported at 1.3 events/1000 catheter days 2

Thrombotic Complications

• Femoral catheterization has significantly higher thrombotic complication rates (21.5%) compared to subclavian sites (1.9%) 6
• For tunneled femoral catheters with exit site at mid-thigh, thrombotic events occurred in only 1.41% of cases 2

Material Considerations

• Most modern central venous catheters are made of silicone or polyurethane 1
• These materials are associated with fewer infections than polyvinyl chloride or polyethylene 1
• Silicone is a soft biocompatible rubber that is one of the least thrombogenic materials 1

Clinical Pearls

• Always select the smallest diameter catheter that will accomplish the clinical goal 1
• Consider duration of intended use when selecting catheter type and size 1
• For pediatric patients, use age-appropriate sizes (e.g., 2.5F for neonates and infants) 3
• For high-flow applications, balance the need for adequate flow with the risk of complications from larger catheters 1