Catheter Drainage: Seldinger Technique

[A]n object in motion tends to stay in motion with the same speed and in the same direction unless acted upon by an unbalanced force. -Newton's First Law of Motion Long and curvy, bad. Short and straight, good. -George Zaleski's advice on catheter insertion

Catheter drainage is among the most fundamental procedures in interventional radiology. Whether you enjoy this procedure or not, there is no disputing the fact that it may be the single most successful and long-lived procedure we perform. When we treat an abscess, we expect to cure the patient. Compare that to stenting a superficial femoral artery or inserting a transjugular intrahepatic portosystemic shunt or declotting a dialysis graft. Nearly all nonvascular visceral interventions from nephrostomy to biliary drainage are variations of abscess drainage. Most fluid collections are treated percutaneously using either the trocar method or the Seldinger technique. For the purposes of this article, the discussion will be limited to the Seldinger technique of drainage catheter insertion. However, the trocar method should not be forgotten and presents a viable and arguably better option for many collections, particularly large ones located superficially.