Migration of a Subcutaneous Contraceptive Device

Uwagbai, Omici N.; Wittich, Arthur C.

doi:10.7556/jaoa.2016.123

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…There are a few reported cases of contraceptive implant embolization to the axillary region, some of which required extraction via a surgical incision. 7 , 11 – 13 There have also been a few reported previous cases of intravascular pulmonary migration of subdermal contraceptive implants. 2 – 4 , 7 , 14 – 20 The exact mechanism by which the implant may embolize is unclear.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery

Akhtar

Bhan

Lim

et al. 2018

OAJC

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The Nexplanon® implant is a commonly used radiopaque contraceptive device that contains progestogen associated with an ethylene vinyl-acetate copolymer resulting in a slow release of the active hormonal ingredient. It is inserted into the subdermal connective tissue and provides contraceptive efficacy for up to 3 years. Device removal for clinical, personal or device “end-of-life span” reasons is straightforward. In rare cases, implant migration can occur locally within centimeters of the insertion site. Distant device embolization is extremely rare and can result in complications including chest pain, dyspnoea, pneumothorax and thrombosis or prevent conception until the active ingredient is depleted. We present one such case, where a Nexplanon® implant embolized into the pulmonary artery of a young female patient. We describe the initial “missed” diagnosis of embolized device on a chest radiograph and subsequent successful percutaneous removal once distant embolization was diagnosed.

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Section: Discussionmentioning

confidence: 99%

Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery

Akhtar

Bhan

Lim

et al. 2018

OAJC

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“…The most common migration site of the implant is the axillary region, which is the first place that should be investigated if the implant cannot be palpated in the upper limb. 16,17 General consensus among case studies is that true migration of the implant, beyond 2 cm from the insertion site, is rare if the insertion was performed properly and the implant can be palpated postinsertion. 18,19 When an implant is deeply inserted, it is critical that its location be confirmed before removal attempts are made.…”

Section: Discussion Visualization Techniquesmentioning

confidence: 99%

Contraceptive Implant Migration and Removal by Interventional Radiology

Zhang

Batur

Martin

et al. 2018

Semin intervent Radiol

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As the reversible contraceptive arm implants grow more popular, there is an increasing need to recognize the complications resulting from implant migration and removal. This review summarizes the findings of imaging and removal methods. When an implant is lost, the axillary region should be investigated first. If the implant still cannot be found, visualization though different methods have been employed for non-radiopaque implants. Real-time fluoroscopic-guided localization and removal can be accomplished for radiopaque Nexplanon. Once the implant has been located, standard removal method and other modified techniques can be used to safely remove the implant depending on the implant's location.

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“…Literature review identifies a small number of case reports of local migration of ENG-IMP 6–12 cm from their insertion site towards the axilla 133–139. In addition, Kang et al 140 reported 11 cases of ENG-IMP migration to the axilla, one to the chest wall, two to the region of the clavicle/“neck line” and one to the shoulder region.…”

Section: Complications Of Implant Insertion and Removalmentioning

confidence: 99%

FSRH Guideline (February 2021) Progestogen-only Implant

2021

BMJ Sex Reprod Health

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Migration of a Subcutaneous Contraceptive Device

Cited by 4 publications

References 2 publications

Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery

Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery

Contraceptive Implant Migration and Removal by Interventional Radiology

FSRH Guideline (February 2021) Progestogen-only Implant

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