Antegrade femoral cannulation is performed with the flow of arterial blood and at what location?

• A. With the flow of arterial blood 2 cm below inguinal ligament at least 1 cm above CFA bifurcation
• B. Against the flow of arterial blood 2 cm below inguinal ligament
• C. With the flow of arterial blood at the CFA bifurcation
• D. With the flow and 2 cm above inguinal ligament

Answer: (A)

Antegrade femoral cannulation relies on entering the common femoral artery in a segment where the vessel is single and stable, so the catheter can be advanced in the direction of arterial flow toward the leg. The preferred site is about 2 cm below the inguinal ligament and at least 1 cm above where the common femoral artery bifurcates into the superficial femoral artery and profunda femoris. This location keeps you in the CFA, avoids puncturing a branch, and allows smooth catheter advancement with the flow. Puncturing closer to or within the bifurcation risks entering branches and complicates catheter control, while puncturing too high above the inguinal ligament is not ideal for this approach.