Guidewire catheter exchange using the Modified Seldinger technique
Abstract:
Background: Guidewire-assisted catheter exchange is a well-established procedure. Current guidelines for venous catheters primarily recommend its use in cases where de novo catheter insertion is challenging while advising against it in suspected or confirmed catheter-related infection. Despite its widespread application in central venous catheter management, there is limited data on guidewire exchange with the Modified Seldinger technique (GWE-MST) kit for peripherally inserted central catheters and midlines.
Objective: Provide a detailed description of the guidewire exchange procedure using a Modified Seldinger kit. Furthermore, our case series seeks to summarize previously published studies related to the infection and thrombosis risks of GWE-MST to enhance the evidence supporting its safety profile.
Methods: To evaluate the safety and feasibility of this approach, this paper presents a case series among 52 patients who underwent guidewire exchange using this technique in a large University Hospital.
Results: Only one catheter-related thrombosis was observed, and no other significant complications were reported. One patient experienced a minor post-procedural hematoma.
Conclusion: These findings suggest that guidewire exchange of peripherally inserted central catheters and midlines using the Modified Seldinger technique kit is a safe and effective alternative. However, further research is warranted to determine the optimal clinical scenarios for its use.
Reference:
Giustivi D, Urso F, Celano R, Bartoli A, La Cava L, Masseroli MM, Calloni M, Taino A, Zappa P, Cogliati C, Foschi A, Gidaro A. The guidewire exchange using the Modified Seldinger technique: A safe alternative for PICC and midlines. J Vasc Access. 2025 Jul 2:11297298251352692. doi: 10.1177/11297298251352692. Epub ahead of print. PMID: 40605358.