Seldinger technique

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A set of equipment to perform the Seldinger technique

The Seldinger technique, also known as Seldinger wire technique, is a

organs. It is named after Sven Ivar Seldinger (1921–1998), a Swedish radiologist who introduced the procedure in 1953.[1]

Uses

The Seldinger technique is used for

artificial pacemaker or implantable cardioverter-defibrillator
, and numerous other interventional medical procedures.

Complications

The initial puncture is with a sharp instrument, and this may lead to

hemorrhage or perforation of the organ in question. Infection is a possible complication, and hence asepsis
is practiced during most Seldinger procedures.

Loss of the guidewire into the cavity or blood vessel is a significant and generally preventable complication.[2]

Description

The desired vessel or cavity is punctured with a sharp hollow needle, with

ultrasound guidance if necessary. A round-tipped guidewire is then advanced through the lumen of the needle, and the needle is withdrawn. A sheath or blunt cannula can now be passed over the guidewire into the cavity or vessel. Alternatively, drainage tubes are passed over the guidewire (as in chest drains or nephrostomies). After passing a sheath or tube, the guidewire is withdrawn.[1]

An introducer sheath can be used to introduce

radiocontrast may be used to visualize organs. Interventional procedures, such as thermoablation, angioplasty, embolisation or biopsy
, may be performed.

Upon completion of the desired procedure, the sheath is withdrawn. In certain settings, a sealing device may be used to close the hole made by the procedure.

  • Step 1
    Step 1
  • Step 2
    Step 2
  • Step 3
    Step 3
  • Step 4
    Step 4
  • Step 5
    Step 5
  • Step 6
    Step 6

A modified technique, known as the accelerated Seldinger technique, has also been described where the needle, guidewire, dilator, and sheath are inserted as one unit.[3]

History

Prior to the description of the Seldinger technique, sharp

trocars were used to create lumens through which devices could be passed. This had a high rate of complications.[4] However, with the introduction of the Seldinger technique, angiography became a relatively risk-free procedure, and the field of interventional radiology
blossomed.

Building on the work of Seldinger,

Charles Dotter and Andreas Gruentzig developed angioplasty
.

References

  1. ^
    PMID 13057644
    .
  2. PMID 11881872
    .
  3. S2CID 54484203
    .
  4. S2CID 42628400
    .

External links

Wikimedia Commons has media related to Seldinger technique.
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