Management of Etonogestrel implant migration into the pulmonary artery

التفاصيل البيبلوغرافية
العنوان: Management of Etonogestrel implant migration into the pulmonary artery
المؤلفون: Hugo Clermidy, Dominique Fabre, Jean Noel Hugues, Carlos Garcia Alonso, Delphine Mitilian, Olaf Mercier, Philippe Brenot, Philippe Charbonneau, Elie Fadel
المصدر: Contraception. 113
سنة النشر: 2021
مصطلحات موضوعية: Drug Implants, Desogestrel, Reproductive Medicine, Databases, Factual, Obstetrics and Gynecology, Humans, Pulmonary Artery
الوصف: To evaluate the relationship between time since contraceptive implant placement and retrieval outcomes in patients with implant migration into the pulmonary artery.We reviewed all cases of pulmonary artery implant migration referred to the Marie Lannelongue hospital from 2015 through 2020. Using our hospital database, we collected patients' clinical data and removal information to assess the success of therapeutic management according to the delay between implant insertion and removal.We identified 8 cases. Physicians located 2 in the upper and 6 in the lower lobe. Five patients had associated pulmonary symptoms, most commonly, chest pain and dyspnea. Physicians attempted an endovascular procedure in all cases with successful removal in 3 patients. In the 5 failures, angiography displayed arterial thrombosis distal to the implant. These patients had successful removal with an open mini-thoracotomy (5 cm). None of the 8 patients had serious post-operative complications. For the 3 patients with successful endovascular retrieval, 2 had early diagnosis (≤ 3 months).Endovascular approach with angiography should be performed as a first line treatment modality. Endothelialization and fibrosis within the vessel represent the principal limitations of endovascular strategy, but a retrieval could be attempted anyway with caution. In case of failure, an open approach is required.When a migration into the pulmonary artery is diagnosed, health care professionals should refer patients as soon as possible to a tertiary center with a vascular surgery and/or interventional radiology and thoracic surgery departments.
تدمد: 1879-0518
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cfc364a15920f3eba11597cae3ce7c93Test
https://pubmed.ncbi.nlm.nih.gov/35351447Test
حقوق: CLOSED
رقم الانضمام: edsair.doi.dedup.....cfc364a15920f3eba11597cae3ce7c93
قاعدة البيانات: OpenAIRE