2017
DOI: 10.1016/j.contraception.2016.11.004
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Looking for a lost subdermal contraceptive implant? Think about the pulmonary artery

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Cited by 17 publications
(15 citation statements)
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“…I nstructions for contraceptive subdermal implant insertion have changed over the past decade, primarily inspired by complications related to deep insertions, including intravascular placement and pulmonary artery migration. [1][2][3][4] The most recent recommendation for optimal placement is between the dermis and the subcutaneous tissue in the area of the arm over the triceps muscle, with the intent to minimize neurovascular injury should deep insertion inadvertently occur.…”
Section: Discussionmentioning
confidence: 99%
“…I nstructions for contraceptive subdermal implant insertion have changed over the past decade, primarily inspired by complications related to deep insertions, including intravascular placement and pulmonary artery migration. [1][2][3][4] The most recent recommendation for optimal placement is between the dermis and the subcutaneous tissue in the area of the arm over the triceps muscle, with the intent to minimize neurovascular injury should deep insertion inadvertently occur.…”
Section: Discussionmentioning
confidence: 99%
“…Searched literature demonstrated nine publications of pulmonary artery migration. [37][38][39][40][41][42][43][44][45] Most cases of significant migration result from the implant being inadvertently inserted into the venous system. Typically, the implant then travels from the basilic vein and embolizes to the pulmonary arteries.…”
Section: Discussion Visualization Techniquesmentioning
confidence: 99%
“…If the implant is not palpable on exam during routine physical exam or at the time of removal attempt, imaging studies should be pursued to localize a potentially migrated device. Initial workup should include an ultrasound and radiograph of the arm to include the axilla [2] , [4] . Nexplanon contains barium sulfate making it more radio-opaque and easier to locate on imaging studies than Implanon, whose use has been discontinued in the United States [1] .…”
Section: Discussionmentioning
confidence: 99%
“…Nexplanon contains barium sulfate making it more radio-opaque and easier to locate on imaging studies than Implanon, whose use has been discontinued in the United States [1] . If these methods do not reveal the implant's location, chest radiograph or CT should be considered to assess for central embolization [2] , [3] , [4] , [5] , [7] , [8] .…”
Section: Discussionmentioning
confidence: 99%
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