Last update:
08-Sep-2020

The Swedish radiologist Sven Ivar Seldinger (1921–1998) was born in Mora, a small town in northern Sweden. Following the completion of his medical studies at the Karolinska Institute in Stockholm, he started his career at the Department of Radiology, Karolinska University Hospital in 1950. His special interest was angiography. In those days, the intravascular administration of contrast media involved catheterisation after a surgical incision of the vessels, either through a small polyethylene catheter placed in the needle or by direct needle puncture. Complications were common and the contrast medium could only be injected relatively slowly. In April 1952, Seldinger had "a severe attack of common sense". He realised the sequence in the procedure of catheter introduction to the vessel should be: needle in – guide-wire in through the needle – needle out – catheter in over the guide-wire – guide-wire out. This revolutionised the vascular access procedure and became widely used in interventional radiology, as well as in other clinical applications in Scandinavia and gradually spread to other clinical settings worldwide. Ever since the introduction of haemodialysis in the 1940s, vascular access had been the method's "Achille's heel", especially as the need for dialysis was continuously increasing. The most important steps in the improvement of haemodialysis were the creation of the Quinton–Scribner shunt in 1960 and later the Cimino–Brescia arteriovenous fistula in 1966. However, an easy method of vascular access for acute therapeutic needs or investigation was missing. The Seldinger technique solved this problem and was unrivalled thanks to its simplicity, quickness, and low risk of complications. Stanley Shaldon introduced this technique in dialysis in 1961. Since then, it has been used for all extracorporeal procedures in dialysis departments, when no other vascular accesses are attainable. Seldinger used this method to perform many interventions, such as catheterisation of the renal artery and selective renal angiography (1955). He returned to Mora in 1966 and worked at the local hospital until his retirement in 1986.

Key words: Dialysis access, Interventional radiology, Seldinger technique.