title: Comparison of a novel real-time SonixGPS needle-tracking ultrasound technique with traditional ultrasound for vascular access in a phantom gel model.
abstract: OBJECTIVE
  Ultrasound-guided percutaneous vascular access for endovascular procedures is well established in surgical practice. Despite this, rates of complications from venous and arterial access procedures remain a significant cause of morbidity. We hypothesized that the use of a new technique of vascular access using an ultrasound with a novel needle-guidance positioning system (GPS) would lead to improved success rates of vascular puncture for both in-plane and out-of-plane techniques compared with traditional ultrasound.
  
  
  METHODS
  A prospective, randomized crossover study of medical students from all years of medical school was conducted using a phantom gel model. Each medical student performed three ultrasound-guided punctures with each of the four modalities (in-plane no GPS, in-plane with GPS, out-of-plane no GPS, out-of-plane with GPS) for a total of 12 attempts. The success or failure was judged by the ability to aspirate a simulated blood solution from the model. The time to successful puncture was also recorded. A poststudy validated NASA Task Load Index workload questionnaire was conducted to assess the student's perceptions of the two different techniques.
  
  
  RESULTS
  A total of 30 students completed the study. There was no significant difference seen in the mean times of vascular access for each of the modalities. Higher success rates for vascular access using the GPS for both the in-plane (94% vs 91%) and the out-of-plane (86% vs 70%) views were observed; however, this was not statistically significant. The students perceived the mental demand (median 12.0 vs 14.00; P = .035) and effort to be lower (mean 11.25 vs 14.00; P = .044) as well as the performance to be higher (mean 15.50 vs 14.00; P = .041) for the GPS vs the traditional ultrasound-guided technique. Students also perceived their ability to access vessels increased with the aid of the GPS (7.00 vs 6.50; P = .007). The majority of students expressed a preference for GPS (26/30, 87%) as opposed to the traditional counterpart.
  
  
  CONCLUSIONS
  Use of the novel SonixGPS needle-tracking ultrasound system (UltraSonix, Richmond, BC, Canada) was not associated with a higher success rate of vascular puncture compared with the traditional ultrasound-guided technique. Assessment of mental task load significantly favored the use of the ultrasound GPS over the traditional ultrasound technique.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kopac
authors.forename: Jerry
authors.initials: J
authors.lastname: Chen
authors.forename: Raymond
authors.initials: R
authors.lastname: Tang
authors.forename: Andrew
authors.initials: A
authors.lastname: Sawka
authors.forename: Himat
authors.initials: H
authors.lastname: Vaghadia
mesh_terms: D001291:Attitude of Health Personnel; D001955:British Columbia; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation*; D016009:Chi-Square Distribution; D002983:Clinical Competence; D018592:Cross-Over Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009339:Needles; D010465:Perception; D019047:Phantoms, Imaging; D011446:Prospective Studies; D011677:Punctures; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000295:instrumentation*; D016526:Workload