A device from Yale University researchers aims to simplify the process of placing a central venous catheter, or central line, in patients. The Ballistra Guidewire Advancer allows the physician to insert a guidewire with one hand and continuously monitor the location of the needle tip via ultrasound. The procedure allows full visibility of the guidewire at all times, and simplifies the process to a few thumb movements.
Traditionally, physicians place central lines to administer medicines, fluids, nutrients, or blood products. Among other steps, the clinician sticks a needle in a large vein of a patient's neck, chest, or groin; threads a wire through the needle into the vein; removes the needle, and then uses the wire to deliver a plastic tube (the "central line") into the vein. A handheld ultrasound image guides the needle’s placement, but must be put down for steps that require a switch of hands.
In the time that the clinician picks up the ultrasound again, the needle can lose access to the vein, puncture through the vein to the adjacent artery, or even enter the lung.
According to the Yale team, the Advancer makes the process safer and faster, especially for less experienced clinicians.
“The doctors love to be able to do multiple tests with one hand and not have to switch hands while there’s a needle in the vein of a patient,” said Dr. Steven Tommasini, assistant professor of orthopedics & rehabilitation and biomedical engineering.
The researchers have used 3D printers to develop multiple iterations of the prototype. This fall, the inventors plan to expand testing, get price estimates for injection-molded manufacturing, and work with regulatory consultantant to achieve a Class 2 device rating.