Intravascular migration of contraceptive implants: two more cases

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• 作者：Sam Rowlands^a ; ^b ; ^{srowlands@bournemouth.ac.uk} ; Diana Mansour^c ; ^{diana.mansour@nuth.nhs.uk} ; Martyn Walling^d ; ^{martyn.belmontdoc@sky.com}
• 关键词：Contraceptive implant ; Intravascular ; Lung ; Pulmonary embolism ; Pulmonary artery
• 刊名：Contraception
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：95
• 期：2
• 页码：211-214
• 全文大小：140 K
• 卷排序：95

文摘

In addition to previously published case reports, further cases of intravascular migration of contraceptive implants have been identified from an information request to two national adverse reaction spontaneous reporting systems. We report on two new cases of insertion into the venous system with subsequent embolism to a pulmonary artery.ConclusionIncorporating barium sulfate into the implant has facilitated diagnosis of these very rare adverse events with the initial diagnosis of embolism to the pulmonary arterial tree made by chest X-ray. Removal of an implant from a segmental branch of a pulmonary artery is technically challenging and not without risks. Unsuccessful removal appears to be preceded by a delay in diagnosis leading to endothelialization of the implant in the pulmonary arterial wall.ImplicationsSubdermal placement of contraceptive implants over the anterior surface of the biceps rather than in the sulcus between the biceps and triceps may negate this rare but reported risk.