# Seldinger technique > Mediated Wiki article. Canonical URL: https://mediated.wiki/source/Seldinger_technique > Markdown URL: https://mediated.wiki/source/Seldinger_technique.md > Source: https://en.wikipedia.org/wiki/Seldinger_technique > Source revision: 1332662877 > License: Creative Commons Attribution-ShareAlike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/) The **Seldinger technique**, also known as **Seldinger wire technique**, is a [medical procedure](/source/Medical_procedure) to obtain safe access to [blood vessels](/source/Blood_vessel) and other hollow [organs](/source/Organ_(anatomy)). It is [named after](/source/Eponym) [Sven Ivar Seldinger](/source/Sven_Ivar_Seldinger) (1921–1998), a [Swedish](/source/Sweden) [radiologist](/source/Radiology) who introduced the procedure in 1953.[1] ## Uses The Seldinger technique is used for [angiography](/source/Angiography), insertion of [chest drains](/source/Chest_drain) and [central venous catheters](/source/Central_venous_catheters), insertion of [PEG](/source/Percutaneous_endoscopic_gastrostomy) tubes using the push technique, insertion of the leads for an [artificial pacemaker](/source/Artificial_pacemaker) or [implantable cardioverter-defibrillator](/source/Implantable_cardioverter-defibrillator), and numerous other interventional medical procedures. ## Complications The initial puncture is with a sharp instrument, and this may lead to [hemorrhage](/source/Hemorrhage) or [perforation](/source/Perforation) of the organ in question. [Infection](/source/Infection) is a possible complication, and hence [asepsis](/source/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](/source/Medical_ultrasonography) guidance if necessary. A round-tipped guidewire is then advanced through the [lumen](/source/Lumen_(anatomy)) of the needle, and the needle is withdrawn. A sheath or blunt [cannula](/source/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](/source/Nephrostomy)). After passing a sheath or tube, the guidewire is withdrawn.[1] An [introducer sheath](/source/Introducer_sheath) can be used to introduce [catheters](/source/Catheter) or other devices to perform endoluminal (inside the hollow organ) procedures, such as [angioplasty](/source/Angioplasty). [Fluoroscopy](/source/Fluoroscopy) may be used to confirm the position of the catheter and to manoeuvre it to the desired location. Injection of [radiocontrast](/source/Radiocontrast) may be used to visualize organs. Interventional procedures, such as [thermoablation](/source/Catheter_ablation), angioplasty, embolisation or [biopsy](/source/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. 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](/source/Trochar) 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](/source/Angiography) became a relatively risk-free procedure, and the field of [interventional radiology](/source/Interventional_radiology) blossomed. Building on the work of Seldinger, [Charles Dotter](/source/Charles_Dotter) and [Andreas Gruentzig](/source/Andreas_Gruentzig) developed [angioplasty](/source/Angioplasty). ## References 1. Seldinger SI (1953). "Catheter replacement of the needle in percutaneous arteriography; a new technique". *Acta Radiologica*. **39** (5): 368–76. [doi:10.3109/00016925309136722](https://doi.org/10.3109/00016925309136722). [PMID 13057644](https://pubmed.ncbi.nlm.nih.gov/13057644) 1. 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](https://doi.org/10.1093/bja/88.1.144). [PMID 11881872](https://pubmed.ncbi.nlm.nih.gov/11881872) 1. Thaut, L; Weymouth, W; Hunsaker, B; Reschke, D (January 2019). "Evaluation of Central Venous Access with Accelerated Seldinger Technique Versus Modified Seldinger Technique.". *The Journal of Emergency Medicine*. **56** (1): 23–28. [doi:10.1016/j.jemermed.2018.10.021](https://doi.org/10.1016/j.jemermed.2018.10.021). [PMID 30503723](https://pubmed.ncbi.nlm.nih.gov/30503723). [S2CID 54484203](https://api.semanticscholar.org/CorpusID:54484203) 1. 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](https://doi.org/10.1016/S0140-6736(05)66878-X). [PMID 16226619](https://pubmed.ncbi.nlm.nih.gov/16226619). [S2CID 42628400](https://api.semanticscholar.org/CorpusID:42628400) ## External links - [Flash animation of the Seldinger technique](http://www.frca.co.uk/article.aspx?articleid=100029) [Archived](https://web.archive.org/web/20061017043934/http://www.frca.co.uk/article.aspx?articleid=100029) 2006-10-17 at the Wayback Machine (FRCA.co.uk) - 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](https://doi.org/10.1016/S0140-6736(05)66878-X). [PMID 16226619](https://pubmed.ncbi.nlm.nih.gov/16226619). [S2CID 42628400](https://api.semanticscholar.org/CorpusID:42628400) --- Adapted from the Wikipedia article [Seldinger technique](https://en.wikipedia.org/wiki/Seldinger_technique) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Seldinger_technique?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.