Central Venous Access

Central Venous Access - Lesson Overview

What Is Central Venous Access?

Central venous access refers to the placement of a catheter into a large, central vein — most commonly the internal jugular, subclavian, or femoral vein — so that its tip rests near the right atrium in the superior or inferior vena cava. Unlike peripheral IVs, central venous catheters (CVCs) provide direct access to high-flow vessels close to the heart, making them indispensable in both acute and long-term patient care.

CVCs are placed for a wide range of clinical indications, including administration of vasopressors, total parenteral nutrition (TPN), chemotherapy, and long-term antibiotics, as well as for hemodynamic monitoring and emergent resuscitation. In interventional radiology, these procedures are performed using real-time imaging guidance — typically ultrasound and fluoroscopy — which dramatically improves safety and success rates compared to landmark-based techniques.

What You'll Learn in This Video

By the end of this lesson, you will be able to:

• Identify the indications and contraindications for central venous catheter placement, including when IR-guided access is preferred over bedside insertion

• Recognize the relevant anatomy of the major central venous access sites — internal jugular, subclavian, axillary, and femoral veins — and understand why site selection matters

• Understand the equipment used in IR-guided central line placement, including catheter types (standard CVC, PICC, tunneled catheter, port-a-cath) and their clinical applications

• Walk through the procedural steps of ultrasound-guided venipuncture and the Seldinger technique, from skin prep to catheter securement

• Recognize intra-procedural imaging landmarks used under fluoroscopy to confirm appropriate catheter tip position

• Identify common complications such as pneumothorax, arterial puncture, air embolism, and catheter malposition — and understand how they are recognized and managed