The Seldinger technique, also known as Seldinger wire technique, is a
medical procedure to obtain safe access to blood vessels and other
hollow organs. It is named after Dr. Sven Ivar Seldinger
(1921–1998), a Swedish radiologist who introduced the procedure in
4 History and impact
6 External links
The desired vessel or cavity is punctured with a sharp hollow needle
called a trocar, with ultrasound guidance if necessary. A round-tipped
guidewire is then advanced through the lumen of the trocar, and the
trocar is withdrawn.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After passing a sheath or tube, the guidewire is withdrawn.
An introducer sheath can be used to introduce catheters or other
devices to perform endoluminal (inside the hollow organ) procedures,
such as angioplasty.
Fluoroscopy may be used to confirm the position
of the catheter and to manoeuvre it to the desired location. Injection
of 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Upon completion of the desired procedure, the sheath is withdrawn.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.
Seldinger technique is used for angiography, insertion of chest
drains and central venous catheters, insertion of PEG tubes using the
push technique, insertion of the leads for an artificial pacemaker or
implantable cardioverter-defibrillator, and numerous other
interventional medical procedures.
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
Loss of the guidewire into the cavity or blood vessel is a significant
and generally preventable complication.
History and impact
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. 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.
^ a b Seldinger SI (1953). "
Catheter replacement of the needle in
percutaneous arteriography; a new technique". Acta radiologica. 39
(5): 368–76. doi:10.3109/00016925309136722.
^ Schummer W, Schummer C, Gaser E, Bartunek R (2002). "Loss of the
guide wire: mishap or blunder?". British journal of anaesthesia. 88
(1): 144–6. doi:10.1093/bja/88.1.144. PMID 11881872.
^ Higgs ZC, Macafee DA, Braithwaite BD, Maxwell-Armstrong CA (2005).
"The Seldinger technique: 50 years on". Lancet. 366 (9494): 1407–9.
doi:10.1016/S0140-6736(05)66878-X. PMID 16226619.
Wikimedia Commons has media related to Seldinger technique.
Flash animation of the
Seldinger technique (FRCA.co.uk)
Fresh frozen plasma
Fresh frozen plasma (
Cryosupernatant + Cryoprecipitate)
Lactated Ringer's, Sodium bicarbonate
Peripheral venous catheter
Peripherally inserted central catheter
Peripherally inserted central catheter (Seldinger technique)
Central venous catheter