The Seldinger 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 from Mora, Dalarna County, who introduced the procedure in 1953. See also Medical doctor (BE), Physician (AE), and Medical school. ... The arterial system The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... In biology, an organ (Latin: organum, instrument, tool) is a group of tissues, which perform a specific function or group of functions. ... An eponym is a person, whether real or fictitious, whose name has (or is thought to have) given rise to the name of a particular place, tribe, discovery, or other item. ... Chest X-ray Radiology traditionally was the branch of medical science dealing with the medical use of X-rays emitted by X-ray machines or other such radiation devices for the purpose of obtaining visual information as part of medical imaging. ... Mora is a Municipality in Dalarna County, in central Sweden. ... Dalarna County, or Dalarnas län is a County or län in middle Sweden. ... 1953 (MCMLIII) is a common year starting on Thursday. ...

Description

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 A round-tipped guidewire is then advanced through the lumen of the trocar, and the trocar is withdrawn.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 After passing a sheath of tube, the guidewire is withdrawn. Medical ultrasonography (sonography) is an ultrasound-based diagnostic imaging technique used to visualize internal organs, their size, structure and any pathological lesions. ... In anatomy, the lumen is the cavity or channel within a tube or tubular structure, such as the vascular lumen of a blood vessel, along which blood flows. ...

If a sheath is used, it 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 visualise organs. Interventional procedures, such as thermoablation, angioplasty, embolisation or biopsy, may be performed. Catheter disassembled In medicine, a catheter is a tube that a health professional may insert into part of the body. ... Angioplasty is the mechanical, hydraulic dilation of an artery lumen which has been narrowed, sometimes totally obstructed, generally due to atheroma (the lesion of atherosclerosis). ... A modern fluoroscope. ... Radiocontrast agents (or simply contrast agents) are compounds used to improve the visibility of internal bodily structures in an X-ray image. ...

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.

Uses

The Seldinger technique is used for angiography, insertion of chest drains and central venous catheters, and numerous other interventional medical procedures. Angiography or arteriography is a medical imaging technique in which an X-ray picture is taken to visualize the inner opening of blood filled structures, including arteries, veins and the heart chambers. ... A chest tube or chest drain is a flexible plastic tube that is inserted through the side of the chest into the pleural space. ... In medicine, a central venous catheter (CVC or central (venous) line) is a catheter placed into a large vein in the neck, chest, or groin. ...

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. A subconjunctival hemorrhage is a common and relatively minor post-LASIK complication. ... A perforation is a hole made by puncturing a surface. ... An infection is the detrimental colonization of a host organism by a foreign species. ... Asepsis is the practice to reduce or eliminate contaminants (such as bacteria, viruses, fungi, and parasites) from entering the operative field in surgery or medicine to prevent infection. ...

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 (Higgs et al 2005). However, with the introduction of the Seldinger technique, angiography became a relatively risk-free procedure, and the field of interventional radiology blossomed. Angiography or arteriography is a medical imaging technique in which an X-ray picture is taken to visualize the inner opening of blood filled structures, including arteries, veins and the heart chambers. ... Interventional Radiology (IR) is a subspecialty of Medical imaging (Radiology) in which minimally invasive procedures are performed using image guidance. ...

Building on the work of Seldinger, Charles Dotter and Andreas Gruentzig developed angioplasty. Andreas R. Gruentzig, 1939-1985, was a German radiologist who first developed successful angioplasty for expanding lumens of narrowed arteries. ... Angioplasty is the mechanical, hydraulic dilation of an artery lumen which has been narrowed, sometimes totally obstructed, generally due to atheroma (the lesion of atherosclerosis). ...

References

• Higgs ZC, Macafee DA, Braithwaite BD, Maxwell-Armstong CA. The Seldinger technique: 50 years on. Lancet 2005;366:1407-9. PMID 16226619.
• Seldinger SI. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta Radiol 1953;39:368-76. PMID 13057644.

The Lancet is a British medical journal, published weekly by the Lancet Publishing Group, part of Reed Elsevier. ...

External link

• Illustrations showing the steps of the Seldinger technique (505 KB PDF)