The guidewire exchange using the Modified Seldinger technique: A safe alternative for PICC and midlines

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.