Evaluierung einer neuen Seldinger-Nadel für computertomografisch gesteuerte Interventionen: Erste Erfahrungen

Abstract

To evaluate a new Seldinger puncture device for computed tomography-guided interventions under difficult conditions, to analyze applicability, and to investigate assets and drawbacks. From November 2007 to March 2008, we performed CT-guided interventions in 16 patients (7 women, 9 men; mean age 62 years old) using a new 20G-Seldinger needle (Sika-Med, Wiehl, Germany). This novel needle serves as a guide for many different interventional devices due to a guide wire welded on the proximal needle end. It allows continuous application of anesthesia via four tiny holes at the distal needle end until the region of interest is reached. Each intervention was subject to difficult interventional conditions. The indications for intervention were drainage (n = 7), Trucut biopsy of tumor (n = 8) and radiofrequency ablation (n = 1). Handling, success, advantages, drawbacks, complications and patient tolerance were noted after each procedure. A pain scale from 1 - 10 was used to grade the pain level during the intervention. All interventions were performed successfully and no severe complications were observed. Patient tolerance was very good resulting in a mean pain score of 2 +/- 1. Regions with dangerous and difficult access were successfully reached with the new Seldinger needle in 15 of 16 cases by dilatation of the puncture tract and continuous administration of local anesthesia via the system. Furthermore, different devices such as Trucut systems and a drainage catheter were able to be inserted without complication via the needle. With a proximal removable luer-lock connection, liquid material was able to be aspirated in six cases. Under difficult interventional conditions, the use of a Seldinger needle as a reliable technique for CT-guided interventions can provide a safe and successful procedure.