Neurovascular injury during removal of levonorgestrel implants

Injury to major neurovascular structures of the upper arm is a complication to be kept in mind, especially during difficult levonorgestrel implant removal. The risk of such an injury may be higher if the implants are inserted deeply over the brachial groove, where four major structures, namely, the basilic vein, the ulnar and median nerves, and the brachial artery, are located.