Rapid and reliable vascular access is critical in trauma and critical care. Central vascular catheterization enables high-volume resuscitation, hemodynamic monitoring, and advanced interventions like ECMO and REBOA. While peripheral access is common, central access is often necessary but requires specialized ultrasound-guided skills, posing challenges in prehospital settings. The complexity arises from deep target vessels and the precision needed for needle placement. Traditional techniques, like the Seldinger method, demand expertise to avoid complications. Despite its importance, ultrasound-guided central access is underutilized due to limited field expertise. While autonomous needle insertion has been explored for peripheral vessels, only semi-autonomous methods exist for femoral access. This work advances toward full automation, integrating robotic ultrasound for minimally invasive emergency procedures. Our key contribution is the successful femoral vein and artery cannulation in a porcine hemorrhagic shock model.

Billions of vascular access procedures are performed annually worldwide, serving as a crucial first step in various clinical diagnostic and therapeutic procedures. For pediatric or elderly individuals, whose vessels are small in size (typically 2 to 3 mm in diameter for adults and less than 1 mm in children), vascular access can be highly challenging. This study presents an image-guided robotic system aimed at enhancing the accuracy of difficult vascular access procedures. The system integrates a 6-DoF robotic arm with a 3-DoF end-effector, ensuring precise navigation and needle insertion. Multi-modal imaging and sensing technologies have been utilized to endow the medical robot with precision and safety, while ultrasound imaging guidance is specifically evaluated in this study. To evaluate in vivo vascular access in submillimeter vessels, we conducted ultrasound-guided robotic blood drawing on the tail veins (with a diameter of 0.7 plus or minus 0.2 mm) of 40 rats. The results demonstrate that the system achieved a first-attempt success rate of 95 percent. The high first-attempt success rate in intravenous vascular access, even with small blood vessels, demonstrates the system's effectiveness in performing these procedures. This capability reduces the risk of failed attempts, minimizes patient discomfort, and enhances clinical efficiency.