Performance and safety of Femorally Inserted Central Catheters in oncological patients: A cases series analysis.

Abstract

Background: Selection of vascular access devices (VADs) is critical for successful intravenous therapy, especially in oncology patients requiring long-term central VADs. In cases where upper-body venous access is not viable, femoral access has traditionally been avoided due to higher infection and thrombosis risks. However, new protocols and technologies have redefined the safety and feasibility of femorally inserted central catheters (FICCs).

Objective: This study evaluates the outcomes of FICC insertions in oncology patients at a tertiary hospital in Spain, using advanced techniques including ultrasound-guided insertion, tunneling, and tip confirmation.

Methods: A retrospective observational study was conducted in 2025 with 25 cancer patients who required elective central DAVs and lacked viable upper-body veins between November 2021 and June 2024. All procedures were performed by an experienced vascular access nurse, following the RaFeVA and SIF protocols. Data on demographics, catheter type, vein selection, complications, and dwell time were collected and analyzed.

Results: A total of 25 FICCs were inserted. The superficial femoral vein was used in 84% of cases. No catheter-related bloodstream infections (CRBSIs) or symptomatic thromboses were reported. Mean dwell time varied according to treatment duration and patient survival, with several catheters remaining functional at data cutoff. Ultrasound-guided tip confirmation ensured proper positioning in the inferior vena cava.

Conclusion: When inserted using modern protocols and technologies, FICCs offer a safe and effective alternative for oncology patients without viable upper-body venous access. This approach minimizes complications and enables timely catheter placement, supporting the broader adoption of lower-body central access in specific patient populations.