On this page...
This page tells you about having a Non-Tunnelled CVC Line Insertion (Vascath). This page is for those patients who have been referred to interventional radiology.
It explains what is involved and what the possible risks are. It is not meant to replace an informed discussion between you and your doctor but can act as a starting point or reminder for such discussions. If you have any questions about the procedure, please ask the doctor who has referred you or the department which is going to perform it.
Your procedure will take place in the Radiology department. The radiology department may also be called the ‘X-ray’ or ‘Imaging’ department. It is the facility in the hospital where radiological examinations are carried out, using a range of x-ray equipment, such as a CT (computed tomography) scanner, an ultrasound machine and an MRI (magnetic resonance imaging) scanner.
The team undertaking your procedure will include an Interventional Consultant Radiologist who performs the procedure and they are doctors specially trained to carry out imaging guided complex procedures. They are supported by specialist nurses who are highly trained in interventional procedures, sedation, recovery and patient support alongside support from radiographers who are highly trained to carry out x-rays and other imaging procedures. There is a possibility that there will be various students and trainees involved as this is a teaching hospital.
A Non-Tunnelled line commonly known as a femoral vascath, is a flexible tube that is put into a large vein in your groin. It is used for giving fluids or medicine into your bloodstream, or for red cell exchange. A femoral line is used for red cell exchange has two ‘lumens’ or ports – one for withdrawing and the other for returning blood. A femoral line is only suitable for short-term use. Your red cell exchange will be carried out by specialist nurses from the apheresis team. When the treatment is finished, the line will be removed.
A femoral line is useful for a red cell exchange if the veins in your arms are difficult to access. If you are not sure why you are being offered a femoral line, please speak to your referring team.
Risks during insertion
Most femoral line insertions go smoothly. There is a very small risk of puncturing a blood vessel in the abdomen or air entering your bloodstream. These complications can be serious, but we take every precaution to prevent them and they are very unlikely to happen. There is also a small risk of puncturing an artery in your groin which could cause bruising.
Bleeding
After the line is removed there could be some bleeding from the groin. We can usually prevent this by pressing on the site as described above and by checking for bleeding before you leave. However, on rare occasions bleeding can start again some time later. As the femoral vein is large, there may seem to be a lot of blood. If this happens, please press on the site until the bleeding stops and lie down if possible. If you are an inpatient, call for assistance. If you are an outpatient, please return to the Apheresis Unit where you had your exchange to have your dressing changed when you are sure the bleeding has stopped.
Infection
Femoral lines used for red cell exchanges usually only stay in for a few hours. This means that they are very unlikely to become infected. If you notice any of the symptoms listed below, either while the line is in or after it has been removed, tell your doctor or nurse straight away:
- a high temperature (over 38°C)
- feeling shivery
- pain, redness or swelling around the insertion site.
If you have an infection, you will need to take a course of antibiotics.
Blood clot
Although rare, it is possible for a blood clot (thrombosis) to form in the vein used for the line. If you notice swelling or pain in the leg or foot, either while the line is in or after it has been removed, let us know straight away. If you have a clot, you will need medication to dissolve it. There is also a small risk of a blood clot on the lungs. This is very rare. If you experience chest pain or sudden shortness of breath, either while the line is in or in the days after it has been removed, go to your local Emergency Department (A&E) or call an ambulance.
Malfunction
In a very small number of patients a femoral line may fail to function properly. If this happens, the line will need to be removed and replaced.
Blockage
Femoral lines can sometimes become blocked. We can usually unblock them by using a special flushing solution.
Scarring
After the line has been removed you will probably have a small scar in your groin (less than half a centimetre long). If you have repeated femoral lines, you can also develop scar tissue under the skin. This is not visible and will not affect your life but it can make it difficult to use the vein for future femoral lines. If you have regular red cell exchanges, you may be offered a more long-term line called a Vortex® port to avoid having to use the femoral veins.
One alternative is to use the veins in both of your arms; another alternative is a Vortex® port, which is a more long-term device used for red cell exchanges. Your doctor or nurse may have suggested a femoral line for you but if you would like more information about Vortex® ports, please talk to the team looking after you or one of the central venous access nurses.
The apheresis team will arrange for you to have any blood tests you may need before the femoral line is inserted.
You need to attend the Imaging Department at the time instructed on your appointment letter. Please take all your medication on the morning of the procedure unless you have been informed to omit it by your doctor or the Imaging department.
On arrival you will be checked into the department by a nurse. The nurse will fill in some paperwork and do some clinical observations-like blood pressure and pulse. The Radiologist will come and explain the procedure and sign off the Consent form with you. This is where you have the opportunity to talk to the Radiologist doing your procedure and they will be able to address any concerns you may have.
This procedure is commonly performed under local anaesthetic, however if you are expecting sedation, it is necessary that you have escort to take you home and stay with you overnight. This is the policy for sedation so if you are expecting sedation, please ensure so you can make the necessary arrangements. If you are having sedation during the procedure, the nurse or radiographer will place a cannula into your vein prior to the procedure.
If you have any allergies, you must let your doctor know.
If possible, try to drink plenty of fluids before you come for your appointment. This makes your veins easier to access.
If you take tablets or injections to thin your blood, these may need to be stopped for a short time. This is to prevent any bleeding during the femoral line insertion. If you are an outpatient, you should discuss this with the doctor who prescribes your blood-thinning medicine. One of the central venous access or apheresis nurses will also talk through the plan with you. If you have ever had an infection called MRSA (methicillin-resistant staphylococcus aureus), please let your doctor or nurse know. You may need to have a nose swab to see if the infection is still present before your femoral line can be put in.
We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with procedure, by law we must ask for your consent and will ask you to sign a Consent form. This confirms that you agree to have the procedure and understand what it involves.
The consent form is a form that both you and the operating doctor sign confirming that you have discussed the procedure and been informed of the risks/benefits/alternatives and have agreed to carry on with the interventional procedure. (You can have a copy of this form to take with you.)
Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish.
You will lie on patient trolley, generally flat on your back. You may have monitoring devices attached to your chest and finger throughout the procedure.
The procedure is performed under sterile conditions and the interventional radiologist and radiology nurse will wear sterile gowns and gloves to carry out the procedure. The radiologist will find a vein in your groin using ultrasound and inject local anaesthetic into the skin to numb it. This will cause some temporary discomfort but will wear off within a few seconds. Once the skin is numb the line insertion is usually pain-free, although you may feel a pushing sensation at times. The nurse will put a dressing over the insertion site to hold the line securely in place. No stitches are needed. It usually takes about 20 minutes to put the line in
Some discomfort may be felt in the skin and deeper tissues during the injection of the local anaesthetic. After this, the procedure should not be painful. There will be a nurse, or another member of clinical staff, standing nearby looking after you. If the procedure does become uncomfortable, please inform the nurse looking after you.
Every patient’s situation is different, and it is not always easy to predict how complex or how straightforward the procedure will be. Generally, the procedure will be over in about 20 minutes.
If needed, the line can be used straight after it has been put in.
You may be taken to the recovery area on a trolley. A recovery nurse may need to carry out routine observations, such as taking your pulse and blood pressure. They will also look at the line insertion site to make sure there is no bleeding around it. You will then get transferred to the apheresis unit or ward bed when required.
Things to look out for at home
It is important that you contact your nurse specialist or the apheresis unit if you notice any of the following:
- a high temperature (over 38°C)
- feeling shivery
- any pain or swelling.
When and how will my line be removed?
The femoral line will usually be removed by the apheresis or ward nurses as soon as your red cell exchange is finished. You may briefly experience some discomfort when the line is removed. After a dressing is applied, you should press on the site for five minutes. You will also need to stay lying down for 25 minutes. If you are an outpatient you will be asked to walk around for a few minutes before you leave. This is to check for any bleeding. You can remove the dressing after 24 hours.
Some of your questions should have been answered on this page but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Make sure you are satisfied that you have received enough information about the procedure.
Contact and references
British Society of Interventional Radiology
Macmillan Cancer Information
For general information about radiology departments, visit The Royal College of Radiologists
NHS Direct
For health advice or information you can call NHS Direct on 0845 45647 or visit the website: www.
The NHS Clinical Knowledge Summaries website: www.
UCL Hospitals cannot accept responsibility for information provided by other organisations.
Please contact the Clinical Nurse Specialist (CNS)
Direct line: Interventional radiology CNS: 0797 487 5629
UCH Switchboard: 020 3456 7890
Address:
Interventional Radiology Imaging Department
University College Hospital
2nd Floor
235 Euston Road
London
NW1 2BU
Admin Queries Email: uclh.
Radiology Admin enquiries phoneline: 020 3447 3267
Website: www.
If you have been referred by the Central venous access team, please contact:
(Monday to Friday, 9am to 5pm)
Telephone: 020 3447 7491
Supportive Care Unit
(Monday to Friday, 8am to 8pm)
Telephone: 020 3447 1808
Out of hours Oncology patients: 07947 959 020
Haematology patients: 07852 220 900
Teenagers and young adults: 07908 468 555
If you are not under any oncology team, please contact our interventional clinical nurse specialist.
Procedures:
The Imaging Department, Level 2 Podium in the main University College Hospital building with the entrance on Euston Road (see map below).
Travelling to the hospital
No car parking is available at the hospital. Street parking is limited and restricted to a maximum of two hours.
Please note the University College Hospital lies outside, but very close to the Central London Congestion Charging Zone.
Tube
The nearest tube stations, which are within two minutes’ walk are:
- Warren Street (Northern and Victoria lines)
- Euston Square (Hammersmith & City, Circle and Metropolitan lines)
Overground trains
Euston, King Cross & St Pancras and Kings Cross Thames link railway stations are within 10-15 minutes’ walk.
Bus
Further travel information can be obtained from http://
Hospital transport service
If you need (and are eligible for) transport, please call:
020 3456 7010 (Mon to Fri 8am - 8pm) to speak to a member of the Transport Assessment Booking Team.
If you have a clinical condition or mobility problem that is unlikely to improve you will be exempt from the assessment process. However, you will still need to contact the assessment team so that your transport can be booked. If your appointment is cancelled by the hospital or you cannot attend it, please call 020 7380 9757 to cancel your transport.
University College Hospital Area Map
Page last updated: 31 July 2024
Review due: 01 July 2026