Ultrasound-Guided Removal of Nonpalpable Subcutaneous Implanted Contraceptive (Implanon)

Implantable progestin-only contraceptives such as Implanon (Organon International, Jersey City, New Jersey) have grown in popularity and are recommended as first-line contraception for women. In rare cases, implants may migrate or become impalpable, requiring localization prior to open removal by plastic surgery or minimally invasive image-guided removal by interventional radiology (IR). A retrospective review of ultrasound (US)-guided Implanon removals within the IR department of a single center between 2010 and 2020 was performed to report on procedure outcomes, including technical success and adverse event rates. The procedure was performed in 115 women with a technical success rate of 95%. The mean duration of the procedure was 14 minutes (SD ± 3.6). Only 1 patient experienced postprocedural fingertip pain and paresthesia, which resolved spontaneously. IR offers an excellent option for minimally invasive US-guided removal of Implanon devices complicated by implant migration, with a high technical success rate and patient satisfaction and low adverse event rate.