Improving central line needle insertions using in-situ vascular reconstructions

ABSTRACT We developed a neck central line insertion guidance system that renders 3D ultrasound (US) surface reconstructions of the carotid artery (CA) and internal jugular vein (IJV), a tracked model of the needle, and needle trajectory on a 2D monitor. Twenty clinicians evaluated this system compared to US-only guidance on a phantom using time and insertion accuracy metrics. The 3D system had a 100% success rate compared to 70% for the US-only system. The average distance from the centre line of the US reconstructed IJV was mm under D guidance compared to mm for US-only. Our system significantly improved needle insertion success rates and targeting accuracy compared to the US-only approach through a radiation-free surface reconstruction of the neck vascular structures. This work has the potential to provide a mobile 3D imaging and visualisation system for needle-based vascular interventions.

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