Fluoroscopic removal of ‘lost thread’ IUCD's: A novel second line technique

AbstractIntrauterine contraceptive devices (IUCDs) with lost threads are an infrequent but growing problem, and there are several successful first-line methods of retrieving the devices. In the event of retrieval failure, we propose a novel second-line technique using an endovascular snare under direct fluoroscopic guidance. A total of 137 women were referred with ‘lost string’ IUCDs and underwent removal using a snare device, designed for endovascular foreign body retrieval, inserted transcervically. The snare is manipulated to catch the stem of the IUCD under C-arm fluoroscopy. The successful removal rate was 89.6%. The average screening time was 3 min 29 s, with a median air kerma of 12.33 mGy and DAP of 985 mGy cm2, which was considered minimal and comparable with similar gynaecological interventional procedures. There were no significant complications, with the procedure being tolerated and pain free in 97.8% of cases.