Etonogestrel implant migration to the vasculature, chest wall, and distant body sites: Cases from a pharmacovigilance database.

To describe clinical outcomes of etonogestrel implant patients with migration to the vasculature, chest wall, and other distant body sites spontaneously reported to the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database.We performed a standardized Medical Dictionary for Regulatory Activities (MedDRA) query in the FAERS database (through November 15, 2015) with reports coded with one or more MedDRA preferred terms (PTs) that indicate complications with device placement or migration of the device from the original site of insertion to the vasculature, chest wall and other distant body sites. We excluded any cases previously described in the medical literature.We identified 38 cases of pronounced etonogestrel implant migration. Migration locations included lung/pulmonary artery (n=9), chest wall (n=1), vasculature at locations other than lung/pulmonary artery (n=14), and extravascular migrations (n=14) to other body sites (e.g., axilla, and clavicle/neck line/shoulder). The majority of cases were asymptomatic and detected when the patient desired implant removal; however, seven cases reported symptoms such as pain, discomfort, and dyspnea in association with implant migration. Three cases also describe pulmonary fibrosis and skin reactions as a result of implant migration to the vasculature, chest wall and other distant body sites. Sixteen cases reported surgical removal in an operating room setting.Our FAERS case series demonstrates etonogestrel implant migration to the vasculature, chest wall, and other body sites distant from site of original insertion.