title: Clinical experience with contrast infusion sonography as an Essure confirmation test.
abstract: OBJECTIVE
  The purpose of this study was to assess the clinical experience, including the feasibility, safety, compliance, and efficacy, of contrast infusion sonography as an Essure (Conceptus Inc, Mountain View, CA) confirmation test.
  
  
  METHODS
  A retrospective chart review and telephone survey were conducted at an academic multispecialty group. The study participants were women with Essure intervention who underwent contrast infusion sonography, transvaginal sonography, and hysterosalpingography as Essure confirmation tests. The main outcome measures included the feasibility, safety, compliance, and efficacy of contrast infusion sonography as a first-line Essure confirmation test.
  
  
  RESULTS
  A total of 118 women had successful bilateral Essure placement. Of the 63 who consented to contrast infusion sonography, 53 (84.1%) had proper bilateral placement and tubal occlusion and were encouraged to rely on Essure. Four were suspected of having unilateral tubal patency; hysterosalpingography in 2 confirmed bilateral tubal occlusion, and 2 were noncompliant with second-line hysterosalpingography. Three patients suspected of having unsatisfactory or uncertain placement on initial transvaginal sonography were encouraged to undergo hysterosalpingography in lieu of contrast infusion sonography, which confirmed unsatisfactory placement in 2 and proper placement and occlusion in 1. Three contrast infusion sonographic procedures could not be completed because of technical issues; therefore, contrast infusion sonography was feasible in 95.2% of the patients (60 of 63). No notable adverse events occurred. Only 17 patients were noncompliant with any confirmation test, yielding an overall compliance rate of 86% (101 of 118). No pregnancies occurred during 669 woman-months of follow-up. The average reimbursement for contrast infusion sonography was US$251.78.
  
  
  CONCLUSIONS
  Preliminary clinical data suggest that contrast infusion sonography is a feasible, safe, and accurate Essure confirmation test, which is well accepted by patients.
authors.affiliation: Department of Gynecology, Section of Minimally Invasive Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, USA. connorv@ccf.org
authors.forename: Viviane F
authors.initials: VF
authors.lastname: Connor
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage; D005187:Fallopian Tubes / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D007263:Infusions, Parenteral; D019919:Prosthesis Implantation / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013246:Sterilization, Tubal / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren