[Duplex ultrasound control of the effectiveness of a newly developed combined pressure clamp for acute and long-term pressure dressings of the femoral artery and vein after heart catheterization]. / Duplexsonographische Effektivitätskontrolle einer neuentwickelten Kombination aus Druckpresse zur Akutkompression und Dauerkompressionsverband von A. and V. fermoralis nach Herzkatheterismus.

After transfemoral angiography the artery has to be manually compressed in order to stop acute bleeding. Then, to prevent retarded bleeding, a continuous pressure dressing has to be fixed for up to 24 h. To simplify this procedure, we developed a novel compression device and tested it in 133 patients. Color-flow-ultra-sonography was used to scan gross alterations such as hematomas, AV-fistulas or pseudoaneurysms, and changes in tissue consistency as well. By the new device it is possible to perform femoral artery compression and to substitute pressure dressing safely and with significantly less expenditure than by the combination of manual compression and pressure dressing. We found a reduction from 18 to 3 min time requirement for primary sealing of the puncture site. Moreover, 86% of patients experienced in both methods--the conventional and the new device--would prefer the new equipment in recatheterization. It is better tolerated than the combination of pressure dressing and manual compression. The device is reusable and the compression is easily and exactly adjustable in a wide pressure range. In comparison with previously described mechanical compression systems the remarkable advantage of our device is to merge the function of compression for sealing of the puncture site and pressure dressing for prevention of retarded bleeding.

[Ambulatory contrast hysterosonography as a possibility for assessing tubal patency]. / Die ambulante Hystero-Kontrast-Sonographie (HKSG) als Möglichkeit zur Kontrolle der Tubendurchgängigkeit.

For the diagnostic evaluation of infertility it is crucial to obtain information on potential abnormalities of the uterus or the fallopian tubes. At present, the following diagnostic methods are available: CO2-pertubation, hysteroscopy, hysterosalpingography (HSG) and chromolaparoscopy (CLP). For the latter procedure, general anaesthesia is required. In a clinical trial 103 patients from our infertility clinic were examined for fallopian tube patency using the contrast agent SH U 454 (Echovist). The new technique hystero-contrast sonography (Hy-Co-Sy) was carried out in an outpatient setting without requiring general anaesthesia. Informed consent was obtain from all patients. A Foley catheter was inserted into the uterine cavity, the balloon was inflated and the contrast medium injected. Distribution of the contrast agent as well as the uterine cavity, the fallopian tubes as well as in the pouch of Douglas was then observed by sonography. In addition to Hy-Co-Sy, 58 patients underwent HSG or CLP. Hy-Co-Sy findings could confirmed by HSG and CLP in 90.6% and 91.6%, respectively. Patients were asked to describe their discomfort on a scale of one to hundred. The average time required for the assessment to tubal patency was 9 minutes. Within 12 months of the Hy-Co-Sy study, 23 out of 60 patients (38.3%) became pregnant. Our study shows that Hy-Co-Sy is a valuable and reliable procedure to assess the uterine cavity and the fallopian tubes in patients undergoing treatment for infertility. The procedure can be performed safely in the office without the need for general anaesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)