Contraindications to Femoral Vein Cannulation, US-Guided Absolute contraindications Untrained or inexperienced ultrasound operator Intra-abdominal hemorrhage or regional trauma (sites that drain into the superior vena cava should be used) Unsuitable femoral vein, thrombosed (uncompressible) or inaccessible as seen by ultrasound Local infection at the insertion site Antibiotic-impregnated catheter in allergic patient Relative contraindications Coagulopathy, including therapeutic anticoagulation * Local anatomic distortion, traumatic or congenital, or gross obesity History of prior catheterization of the intended central vein Uncooperative patient (should be sedated if necessary) Ambulatory patient * Therapeutic anticoagulation (eg, for pulmonary embolism) increases the risk of bleeding with femoral vein cannulation, but this must be balanced against the increased risk of thrombosis (eg, stroke) if anticoagulation is reversed.