Migration of a Subdermal Contraceptive Implant into Left Pulmonary Artery: A Case Report and Literature Review

Long-acting contraceptives including subdermal implants are reversible methods considered as first-line choice from National and International Guidelines due to their high efficacy not related to patient adherence. We report the first Italian case of an asymptomatic Nexplanon migration to a pulmonary artery in a 36-year-old Caucasian female patient. On chest CT a radiopaque foreign body, with a thread-like appearance, approximately 40 mm long and approximately 4 mm thick, located endo-luminally between the left lower interlobar branch and a segmental branch of the left pulmonary artery tributary to the apical segment of the lower lobe was found. A successful removal of the implant displaced in left pulmonary artery via right transfemoral venous access was performed by endovascular surgeon. Healthcare providers training in subdermal implant insertion is needed for correct device placement in order to reduce risk of complications.