The Seldinger technique is the mainstay of vascular and other luminal access in interventional radiology.
The Seldinger technique was first described in 1953 by Sven-Ivar Seldinger (1921-1998), a pioneering Swedish interventional radiologist. 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.
- digital subtraction angiography
- insertion of central venous catheters
- insertion of chest drains
- insertion of pacemaker leads or implantable cardioverter-defibrillators
- insertion of PEG tubes
Practically-speaking, the majority of interventional diagnostic and therapeutic radiological procedures employ the Seldinger technique for initial vascular access.
- 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- guidewire is withdrawn leaving the introducer sheath in situ through which catheters and other medical devices can be introduced
- failed access
- perforation of viscus
- guidewire embolus
- pseudoaneurysm formation
- 1. Seldinger SI. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiologica. 39 (5): 368-76. Pubmed