Percutaneous
Encyclopedia
In surgery
, percutaneous pertains to any medical procedure where access to inner organs or other tissue is done via needle
-puncture of the skin, rather than by using an "open" approach where inner organs or tissue are exposed (typically with the use of a scalpel
).
The percutaneous approach is commonly used in vascular procedures. This involves a needle catheter
getting access to a blood vessel, followed by the introduction of a wire through the lumen
(pathway) of the needle. It is over this wire that other catheters can be placed into the blood vessel. This technique is known as the modified Seldinger technique
.
More generally, "percutaneous", via its Latin roots means, 'by way of the skin'. An example would be percutaneous drug absorption from topical
medications. More often, percutaneous is typically used in reference to placement of medical devices using a needle stick approach.
In general, percutaneous refers to the access modality of a medical procedure, whereby a medical device is introduced into a patient's blood vessel via a needle stick. This is commonly known as the "Seldinger Technique" Seldinger technique
named after Dr. Sven Ivar Seldinger. The technique involves placing a needle through the skin and into a blood vessel, such as an artery or vein, until bleedback is achieved. This is followed by introduction of a flexible "introducer guide wire" to define the pathway through the skin and into the passageway or "lumen" of the blood vessel. The needle is then exchanged for an "introducer sheath
" which is a small tube that is advanced over the introducer guide wire and into the blood vessel. The introducer guide wire is removed, and exchanged for a catheter or other medical device to be used to deliver medication or implantation of a medical implant such as a filter or a stent into the blood vessel.
The benefit of a percutaneous access is in the ease of introducing devices into the patient without the use of large cut downs, which can be painful and in some cases can bleed out or become infected. A percutaneous access requires only a very small hole through the skin, which seals easily, and heals very quickly compared to a surgical cut down.
Percutaneous access and procedures almost exclusively refer to catheter procedures such as PTA ballooning, stent delivery, filter delivery, cardiac ablation, and peripheral or neurovascular catheter procedures.
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, percutaneous pertains to any medical procedure where access to inner organs or other tissue is done via needle
Trocar
A trocar is a medical instrument with a sharply pointed end, often three-sided, that is used inside a hollow cylinder to introduce this into blood vessels or body cavities...
-puncture of the skin, rather than by using an "open" approach where inner organs or tissue are exposed (typically with the use of a scalpel
Scalpel
A scalpel, or lancet, is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, and various arts and crafts . Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have attached, resharpenable blades or, more commonly, non-attached, replaceable...
).
The percutaneous approach is commonly used in vascular procedures. This involves a needle catheter
Catheter
In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...
getting access to a blood vessel, followed by the introduction of a wire through the lumen
Lumen (anatomy)
A lumen in biology is the inside space of a tubular structure, such as an artery or intestine...
(pathway) of the needle. It is over this wire that other catheters can be placed into the blood vessel. This technique is known as the modified Seldinger technique
Seldinger technique
The Seldinger technique is a medical procedure to obtain safe access to blood vessels and other hollow organs. It is named after Dr. Sven-Ivar Seldinger , a Swedish radiologist from Mora, Dalarna County, who introduced the procedure in 1953....
.
More generally, "percutaneous", via its Latin roots means, 'by way of the skin'. An example would be percutaneous drug absorption from topical
Topical
In medicine, a topical medication is applied to body surfaces such as the skin or mucous membranes such as the vagina, anus, throat, eyes and ears.Many topical medications are epicutaneous, meaning that they are applied directly to the skin...
medications. More often, percutaneous is typically used in reference to placement of medical devices using a needle stick approach.
In general, percutaneous refers to the access modality of a medical procedure, whereby a medical device is introduced into a patient's blood vessel via a needle stick. This is commonly known as the "Seldinger Technique" Seldinger technique
Seldinger technique
The Seldinger technique is a medical procedure to obtain safe access to blood vessels and other hollow organs. It is named after Dr. Sven-Ivar Seldinger , a Swedish radiologist from Mora, Dalarna County, who introduced the procedure in 1953....
named after Dr. Sven Ivar Seldinger. The technique involves placing a needle through the skin and into a blood vessel, such as an artery or vein, until bleedback is achieved. This is followed by introduction of a flexible "introducer guide wire" to define the pathway through the skin and into the passageway or "lumen" of the blood vessel. The needle is then exchanged for an "introducer sheath
Introducer sheath
An introducer sheath is a surgery tool that consists of a tube that is inserted into the body to provide an access point and allow the insertion of other instruments into an artery. The introducer sheath is used during percutaneous procedures such as angiography, angioplasty and stent placement...
" which is a small tube that is advanced over the introducer guide wire and into the blood vessel. The introducer guide wire is removed, and exchanged for a catheter or other medical device to be used to deliver medication or implantation of a medical implant such as a filter or a stent into the blood vessel.
The benefit of a percutaneous access is in the ease of introducing devices into the patient without the use of large cut downs, which can be painful and in some cases can bleed out or become infected. A percutaneous access requires only a very small hole through the skin, which seals easily, and heals very quickly compared to a surgical cut down.
Percutaneous access and procedures almost exclusively refer to catheter procedures such as PTA ballooning, stent delivery, filter delivery, cardiac ablation, and peripheral or neurovascular catheter procedures.