ABSTRACT

Vascular access to the central circulation is possible via many different routes, each of which carries advantages and disadvantages and potential complications.

Sites of vascular access:

Venous In order of frequency of use:

femoral vein (right or left, occasionally simultaneously) internal jugular vein (most often right) subclavian vein umbilical vein (predominantly used for balloon atrial septostomy) umbilical artery hepatic vein direct transthoracic cardiac puncture

Arterial

femoral artery brachial artery axillary artery carotid artery umbilical artery direct cardiac puncture.