ICM-II: ABDOMEN, changing CVL over a wire

Step 1 shows the initial catheter in place.

In step 2, a wire is placed through the existing catheter.

In step 3, the catheter is removed, leaving the wire in place in step 4.

In step 5, a new catheter is treaded over the wire, and into the vessel in step 6.

In step 7, the wire is removed, leaving the new catheter in place.

When a catheter has been in place about a week, the surface of the catheter becomes contaminated by skin flora. A new catheter is needed, but it is desirable to minimize the number of punctures of the large central veins, if possible. For this reason, the old catheter can be exchanged for a new catheter by using a wire to guide the new catheter through the same puncture in the vessel. This is called the Seldinger technique and is illlustrated here.