Key result
Endovascular intervention successfully retrieves a migrated Nexplanon implant from the pulmonary artery without complications.
Why the study?
Pulmonary embolization of contraceptive implants like Nexplanon is remarkably rare and prevention guidelines are lacking.
Case Report (n=1)
Endovascular intervention can successfully and safely retrieve a migrated contraceptive implant from the pulmonary artery.
May support endovascular retrieval for rare migrations; leaves open need for systematic safety data before wider use.
INTRODUCTION: 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. PATIENT CONCERNS AND DIAGNOSIS: We report one of the rare cases of asymptomatic Nexplanon pulmonary embolism in a 26-year-old female. INTERVENTIONS AND OUTCOMES: An endovascular intervention successfully retrieved the device from the lateral segment right middle lobe pulmonary artery without any complications. CONCLUSION: 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.
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Hindy et al. (2020) conducted a case report in Nexplanon pulmonary embolism (n=1). Endovascular retrieval was evaluated on Device retrieval and complications. An endovascular intervention successfully retrieved a migrated Nexplanon contraceptive implant from the pulmonary artery of a 26-year-old female without any complications.
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