Endovascular retrieval of contraceptive implant embolized to pulmonary artery

Wilcox, Kyle K.; Turcer, Filip; Soltes, George D.; Shin, David S.

doi:10.1016/j.radcr.2018.08.034

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…Previous reporting describes the two main options for contraceptive device removal: endovascular approaches [ 5 , 9 – 17 ] and surgical approaches [ 4 , 6 , 18 , 19 ]. In the literature, we found 14 reports of removal attempts as the first therapeutic option, 4 of which were done surgically and 10 endovascularly (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, we found 14 reports of removal attempts as the first therapeutic option, 4 of which were done surgically and 10 endovascularly (Table 1 ). Two endovascular techniques have been described for subcutaneous device removal: the aspiration technique [ 14 ] and the loop snare technique [ 5 , 9 – 13 , 15 – 17 ]. The loop snare technique is the first choice to attempt removal of an intravascular foreign body.…”

Section: Discussionmentioning

confidence: 99%

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Endovascular retrieval of a migrated contraceptive implant into the pulmonary artery : case report and review of literature

Grange,

Magand,

Grand

et al. 2024

CVIR Endovasc

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Background The migration of contraceptive devices into pulmonary arteries is extremely rare, reported to be 1 in 100,000. Case presentation A 19-year-old female presented no sensation of a contraceptive implant in her arm which had been placed one year prior. A CT scan confirmed that the implant had migrated into the left lower segmentary pulmonary artery. After a multidisciplinary meeting, an endovascular approach was attempted. Following right femoral venous access, a 8F NeuronMax® introducer was placed into the left pulmonary artery under fluoroscopic guidance. The contraceptive device was removed using a 25-mm loop snare, with a proximal capture technique. The patient was discharged the following day, with no reported complications. Conclusion In cases of contraceptive device migration, the first medical decision involves deciding between removal or 'watching and waiting'. Previous reports describe two removal options: endovascular or surgical approaches. Fourteen reports have been published, with high technical success and low rates of complications. The loop snare technique is described as the optimal technique for an endovascular approach. Due to their invasive nature, surgical approaches should be reserved for cases of endovascular removal failure, after evaluating risks and benefits. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endovascular retrieval of a migrated contraceptive implant into the pulmonary artery : case report and review of literature

Grange,

Magand,

Grand

et al. 2024

CVIR Endovasc

View full text Add to dashboard Cite

show abstract

“…To our knowledge, there have been 12 reported cases of contraceptive implants embolizing to the pulmonary vascular system, a few of which previously retrieved by endovascular techniques, mostly using a snare [10] . Other removal techniques include video-assisted thoracoscopic surgery and thoracotomy [11] .…”

Section: Discussionmentioning

confidence: 99%

Aspiration technique for percutaneous endovascular retrieval of contraceptive device embolized to the pulmonary vasculature

Nascimento

Villiers

Chia

et al. 2021

Radiology Case Reports

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Contraceptive implant migration into the pulmonary circulation is an uncommon, but potentially serious complication. We describe an “aspiration” technique for percutaneous retrieval of a contraceptive implant from a subsegmental pulmonary artery, using a Penumbra Neuron MAX 088 guiding catheter and a Merit Medical VacLok Vacuum Pressure Syringe, as an alternative to the previously described snare technique. Our patient had an uneventful recovery and was discharged home on the same day.

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“…Contraceptive implant embolization into the pulmonary vasculature have also been reported. If previously discussed methods do not localize the device in the arm, chest radiograph or computed tomography (CT) should be considered for possible central embolization [10] .…”

Section: Discussionmentioning

confidence: 99%

Nexplanon removal from intramuscular implantation in biceps: case report

Kong

Alfonso²,

Pineda³

et al. 2021

Radiology Case Reports

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Contraceptive implant devices are relatively safe devices, but complications arise when implants become nonpalpable, and cannot be safely removed. In this case report, we describe the location of an implant in the subfascial plane of the upper arm, the diagnostic imaging findings we encountered during the workup, and the procedure necessary to remove it. We demonstrated that if the device is in close proximity to the fascia, it may be difficult to distinguish from the fascia on magnetic resonance imaging. Nonetheless, fluoroscopy and ultrasound easily distinguished the device from the surrounding tissue and allowed localization intraoperatively.

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Endovascular retrieval of contraceptive implant embolized to pulmonary artery

Cited by 8 publications

References 7 publications

Endovascular retrieval of a migrated contraceptive implant into the pulmonary artery : case report and review of literature

Endovascular retrieval of a migrated contraceptive implant into the pulmonary artery : case report and review of literature

Aspiration technique for percutaneous endovascular retrieval of contraceptive device embolized to the pulmonary vasculature

Nexplanon removal from intramuscular implantation in biceps: case report

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