ABSTRACT
PURPOSE: Investigation of a technique for nonsurgical female sterilization. MATERIALS AND METHODS: A custom designed platinum microcoil with Dacron fibers was placed unilaterally into a fallopian tube and uterine horn of 10 rabbits after transcervical selective tubal catheterization with use of fluoroscopic guidance. The contralateral uterus and fallopian tube served as controls. After the rabbits were bred, pregnancy was determined by palpation and confirmed at autopsy. Postmortem histopathologic evaluation of uteri and fallopian tubes was performed. RESULTS: Nine of the 10 rabbits became pregnant. None of the animals had embryos on the microcoil side. Nine rabbits had a total of 45 embryos on the control side. One animal failed to become pregnant on either side. The microcoil remained in good position in all 10 rabbits. There was a microcoil-associated, mild inflammatory tissue response in the uteri and fallopian tubes. CONCLUSION: A platinum occlusion microcoil placed in a utero-tubal location has potential as a means for nonsurgical female sterilization.
PIP: At Milton S. Hershey Medical Center in Hershey, Pennsylvania, researchers used fluoroscopy to guide transcervical selective tubal catheterization in order to correctly insert a custom-designed platinum microcoil with Dacron fibers 1.5-6 cm into a fallopian tube and 1.5-5.5 cm into a uterine horn of 10 rabbits. The fallopian tube and uterine horn on the opposite side were the controls. The researchers sacrificed the rabbits to conduct histopathologic examination of the uteri and fallopian tubes in order to determine the presence or absence of embryos. One rabbit had no embryos on either side, even after 4 breeding attempts. Among the remaining 9 rabbits, there were no embryos on the microcoil side and 45 embryos on the control side. The position of the microcoil did not change in any rabbit. The microcoil caused a mild inflammatory tissue response in the uteri and fallopian tubes. Longer-term studies in more animals are necessary to confirm the efficacy and safety of this sterilization method as well as to determine the potential for retrievability of the microcoil and reversibility of the sterilization effect. In conclusion, a uterotubal coil may someday be a safe, effective, minimally invasive means of female sterilization.
Subject(s)
Cervix Uteri , Intrauterine Devices , Sterilization, Tubal/methods , Animals , Cell Division , Equipment Design , Fallopian Tubes/pathology , Female , Follow-Up Studies , Hysterosalpingography , Male , Platinum , Polyethylene Terephthalates , Pregnancy , Rabbits , Sterilization, Tubal/instrumentation , Uterus/pathologyABSTRACT
PURPOSE: To compare bedside insertion of peripherally inserted central catheters (PICCs) by specially-trained nurses with insertion by cardiovascular and interventional radiologists. MATERIALS AND METHODS: Nurses performed 327 bedside insertions with a palpatory, through-the-needle technique in 301 patients. Radiologists performed 542 insertions with a venographic-fluoroscopic direct puncture and sheath technique in 354 patients. RESULTS: A total of 869 PICCs were inserted in 655 patients. Compared with the first interval of the study (reported previously), bedside technical success improved from 74% to 82.6%, technical success decreased from 98.6% to 98.2%, and the service interval for a given PICC decreased from 72.7 to 28.1 days (because PICCs were used instead of peripheral intravenous lines). Rates of thrombophlebitis and infection remained low. Device failure continued to be a problem. About 25% of patients needed insertion of more than one PICC to complete therapy. CONCLUSION: Bedside insertion by specially trained nurses is less costly than insertion by radiologists, but radiologists are needed for difficult initial insertions, PICC salvage, and PICC exchange.
