Seeing the Whole Vein, Not Just a Dot: A New Ultrasound Guidance Method for Better PIVC Placement

Study Overview

First-pass peripheral intravenous catheter (PIVC) failure can be as high as 40%, and finding/aligning with the vein is often the hardest part—especially for less experienced inserters. This benchtop study tested a novel ultrasound-based prototype that shows a coronal “pathway” view (a visual track of the vessel path) and compared it to standard point localisation (a single ultrasound frame) in untrained users using tissue and vessel-mimicking phantoms.

Fourteen untrained investigators performed cannulation attempts using both guidance approaches, and the study measured success and accuracy outcomes.

Key Findings

- Higher first-pass success with pathway visualisation (but not statistically significant)
First-pass success was 85.7% with pathway visualisation vs 71.4% with point localisation. Failure rates were 14.3% vs 28.6%.

- Placement accuracy improved meaningfully
Pathway visualisation produced a much smaller cannula tip-to-vessel distance.

- Angle alignment was far better
Insertions guided by pathway visualisation aligned closer to the intended angle.

- Technique factors were explored for future design
The study also examined user factors (handedness, familiarity, grip technique) to inform how the prototype and training guidance could be improved.

Implications

This study suggests an important idea: helping users visualise the vessel pathway—not just locate a point—may improve how accurately they steer the cannula into the vein. Even with untrained participants, pathway visualisation improved key accuracy measures and showed a trend toward better first-pass success.

While these results come from a controlled benchtop environment (not real patients), they support further testing in clinical settings—especially for difficult IV access (DIVA) situations where alignment and precision are often the difference between one attempt and many.

Read More:https://link.springer.com/article/10.1007/s10439-025-03899-5 

Authors: Michael D. Liddelow; Ellaby L. Hansen; Phuoc Hao Ho; Peter J. Carr; Barry J. Doyle; Nikhilesh Bappoo