Indications for Femoral Vein Cannulation, US-Guided Secure or long-term venous access that is not available using other sites Inability to obtain peripheral venous access or intraosseous infusion IV infusion of fluids and drugs for patients in cardiac arrest IV infusion of concentrated or irritating fluids IV infusion of high flows or large fluid volumes if placement of large-bore (eg, 18 or 16 gauge) peripheral venous catheters or other CVCs is not feasible Hemodialysis or plasmapheresis Transvenous cardiac pacing (see video How to Insert a Transvenous Pacemaker) or pulmonary arterial monitoring (Swan-Ganz catheter) * Placement of inferior vena cava filter Need for IV access in patients with malignant superior vena cava syndrome Central venous access above the diaphragm, unless contraindicated, is generally preferred to femoral venous access in patients who require central venous access.