A hypodermic needle outer surface deflects ultrasound signals hitting the surface. The reflected signals depend on the surface which the ultrasound signal hits. According to the invention the outer surface of the needle, beginning at the tip or cutting edge of the needle featuring any one or more of: a) dimples having one or more distinct patterns; b) pits, randomly scattered; and, c) double helix, i.e., two grooves starting at an angle apart, preferably 180 degrees, and spiraling backwards in a helical fashion from the tip. By periodically repeating different pattern(s) for a predetermined length of the needle the position of the needle can be accurately identified using ultrasound imaging. The needle, in different lengths and gauges, can be used to facilitate stenting of the carotid artery as well as other ultrasound guided procedures such as biopsies, drainages / aspirations, solid organ tumor ablations and vascular access in general.