Seldinger technique

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The Seldinger technique is the mainstay of vascular and other luminal access in interventional radiology.

History

The Seldinger technique was first described in 1953 by Sven-Ivar Seldinger (1921-1998), a pioneering Swedish interventional radiologist (a rare example of Stigler's law of eponymy being wrong).

Prior to this procedure, sharp large-bore trocars were employed to gain arterial access, resulting in a high rate of complications and limiting its use to larger arteries. While working at the Karolinska Hospital he introduced a novel method of gaining vascular access using a hollow needle, exchange wire, and catheter, which enabled radiologists to perform angiography in a relatively risk-free manner and thus lead to the emergence of minimally invasive procedures.

Uses

Practically-speaking, the majority of interventional diagnostic and therapeutic radiological procedures employ the Seldinger technique for initial vascular access.

Technique

  • desired vessel or cavity is punctured using a trocar (hollow needle)
  • soft curved tip guide wire is then inserted through the trocar and advanced into the lumen
  • guidewire is held secured in place whilst the introducer trocar is removed
  • large-bore sheath/cannula/catheter is passed over the guidewire into the lumen/cavity
  • guidewire is withdrawn leaving the introducer sheath in situ through which catheters and other medical devices can be introduced

    • Complications