Nexplanon migration into a subsegmental branch of the pulmonary artery: A case report and review of the literature.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
entrez:
25
1
2020
pubmed:
25
1
2020
medline:
1
2
2020
Statut:
ppublish
Résumé
Nexplanon is a 4 cm rod-shaped barium sulphate coated contraceptive implant with a usual subdermal insertion in the inner non-dominant upper arm. Complications proper to subdermal contraceptive implants are unusual and principally localized and minor, comprising infection at the site of implantation, hematoma, abnormal scar development, or local nerve and blood vessel injuries. Infrequently, contraceptive implant migration can happen, though habitually not far from the site of insertion. Pulmonary embolization of the device is remarkably rare and can present with symptoms such as chest pain or dyspnea. We report one of the rare cases of asymptomatic Nexplanon pulmonary embolism in a 26-year-old female. An endovascular intervention successfully retrieved the device from the lateral segment right middle lobe pulmonary artery without any complications. Several cases of contraceptive implant migration into the pulmonary artery have been reported to this day. Preventing this life-threatening complication is challenging, and yet, no clear guidelines have been established.
Identifiants
pubmed: 31977894
doi: 10.1097/MD.0000000000018881
pii: 00005792-202001240-00053
pmc: PMC7004701
doi:
Substances chimiques
Contraceptive Agents, Hormonal
0
Drug Implants
0
etonogestrel
304GTH6RNH
Desogestrel
81K9V7M3A3
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e18881Références
Alvarez-Sanchez F, Brache V, Faundes A. Recent experience with and future directions of contraceptive implants and injectable contraceptives. Curr Opin Obstet Gynecol 1993;5:805–14.
Huber J, Wenzl R. Pharmacokinetics of Implanon. An integrated analysis. Contraception 1998;58: (6 Suppl): 85S–90S.
Balogun OR, Olaomo N, Adeniran AS, et al. Implanon sub-dermal implant: an emerging method of contraception in Ilorin, Nigeria. J Med Biomed Sci 2014;3:1–5.
James P, Trenery J. Ultrasound localisation and removal of non-palpable Implanon implants. Aust N Z J Obstet Gynaecol 2006;46:225–8.
Ramdhan RC, Simonds E, Wilson C, et al. Complications of subcutaneous contraception: a review. Cureus 2018;10:e2132.
Ismail H, Mansour D, Singh M. Migration of Implanon. J Fam Plann Reprod Health Care 2006;32:157–9.
Chung M, Loudill C, Wieler M, et al. Endovascular retrieval of Nexplanon from the distal pulmonary artery. J Vasc Interv Radiol 2017;28:466–7.
Kang S, Niak A, Gada N, et al. Etonogestrel implant migration to the vasculature, chest wall, and distant body sites: cases from a pharmacovigilance database. Contraception 2017;96:439–45.
Patel A, Shetty D, Hollings N, et al. Contraceptive implant embolism into the pulmonary artery. Ann Thorac Surg 2014;97:1452.
O’ Brien A, O’Reilly MK, Sugrue G, et al. Subdermal contraceptive implant embolism to a pulmonary artery. Ann Thorac Surg 2015;99:2254–5.
Heudes P-M, Laigle Querat V, Darnis E, et al. Migration of a contraceptive subcutaneous device into the pulmonary artery. Report of a case. Case Rep Womens Health 2015;8:6–8.
D’Journo XB, Vidal V, Agostini A. Intravascular pulmonary migration of a subdermal contraceptive implant. Ann Thorac Surg 2015;99:1828.
Thomas PA, Di Stefano D, Couteau C, et al. Contraceptive implant embolism into the pulmonary artery: thoracoscopic retrieval. Ann Thorac Surg 2017;103:e271–2.
Barlow-Evans R, Jaffer K, Balogun M. Migration of a Nexplanon contraceptive implant to the pulmonary artery. BMJ Case Rep 2017;2017doi: 10.1136/bcr-2017-219259.
doi: 10.1136/bcr-2017-219259
Choi JH, Kim H-Y, Lee SS, et al. Migration of a contraceptive subdermal device into the lung. Obstet Gynecol Sci 2017;60:314–7.
Kew EP, Senanayake E, Djearaman M, et al. Migration of contraceptive implant into the left pulmonary arterial system. Asian Cardiovasc Thorac Ann 2017;25:537–9.
Gao GT, Binder W. Embolization of a contraceptive implant into the pulmonary vasculature in an adolescent female. Am J Emerg Med 2018;36:1122e1–2.
Akhtar MM, Bhan A, Lim ZY, et al. Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery. Open Access J Contracept 2018;9:57–61.