Introduction
perforation
Current guidelines recommend ultrasound guidance for central venous catheter (CVC) insertion [For optimal safety, ultrasound-guided CVC insertion requires to visualize the vessel and the needle. Two approaches are available to visualize the needle: the out-of-plane (OOP) approach and the in-plane (IP) approach [Conversely, with IP approach, the needle is within the plane of the ultrasound beam and is tracked from skin's perforation to vessel penetration. As a result, IP approach might enhance safety by minimizing the risk of injury to adjacent structures. However, IP approach requires accurate needle alignment with the ultrasound beam making this approach highly demanding. Needle guiding devices or methods to facilitate IP approach are available but tend to be expensive (several hundred €), sometimes specific to particular probes, and remain poorly investigated so far [