Intracardiac and Pulmonary Cement Embolism after Percutaneous Vertebroplasty
https://doi.org/10.18087/cardio.2019.4.10255
Abstract
The article presents a clinical case of embolism with bone cement of the right ventricle of the heart and pulmonary artery after percutaneous vertebroplasty in a patient aged 63 years. According to the results of a comprehensive examination using ultrasound and x-ray methods, three foreign bodies were found: in the right ventricle cavity, in the trunk of the pulmonary artery, in the branches of the left pulmonary artery. Considering the stable condition, normal blood oxygen saturation, the lack of influence of formations on intracardiac hemodynamics, it was decided to refrain from surgery, since the risk of intervention exceeded the possible benefit. Conservative treatment tactics and dynamic observation were chosen. The literature data on the frequency of such events and tactics of management of these patients are presented.
About the Authors
M. N. Alekhin
Central Clinical Hospital of the Management Affair of President RF
Russian Federation
MD, professor
Russian Federation
MD, professor
A. V. Ter-Akopian
Central Clinical Hospital of the Management Affair of President RF, Moscow
Russian Federation
Russian Federation
A. S. Abramov
Central Clinical Hospital of the Management Affair of President RF, Moscow
Russian Federation
Russian Federation
A. V. Skripnikova
Central Clinical Hospital of the Management Affair of President RF, Moscow
Russian Federation
Russian Federation
References
1. Usikov V.D., Ptashnikov D.A., Magomedov Sh.Sh., Dokish M.Yu., Karagodin D.Ph. Percutaneous vertebroplasty in patients with metastases in spine. Traumatology and orthopedics of Russia. 2008;2(48):49–52.
2. Chen H-L, Wong C-S, Ho S-T, Chang F-L, Hsu C-H, Wu C-T. A Lethal Pulmonary Embolism During Percutaneous Vertebroplasty. Anesthesia & Analgesia. 2002;95(4):1060–2. DOI: 10.1097/00000539-200210000-00049
3. Monticelli F, Meyer HJ, Tutsch-Bauer E. Fatal pulmonary cement embolism following percutaneous vertebroplasty (PVP). Forensic Science International. 2005;149(1):35–8. DOI: 10.1016/j.forsciint.2004.06.010
4. Stricker K, Orler R, Yen K, Takala J, Luginbuhl M. Severe Hypercapnia Due to Pulmonary Embolism of Polymethylmethacrylate During Vertebroplasty: Anesthesia & Analgesia. 2004;1184–6. DOI:10.1213/01.ANE.0000104585.83801.C5
5. Yoo KY, Jeong SW, Yoon W, Lee J. Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate. Spine. 2004;29(14):E294-297. PMID:15247590
6. Llanos RA, Viana-Tejedor A, Abella HR, Fernandez-Avilés F. Pulmonary and intracardiac cement embolism after a percutaneous vertebroplasty. Clinical Research in Cardiology. 2013;102(5):395–7. DOI: 10.1007/s00392-013-0542-9
7. Cadeddu C, Nocco S, Secci E, Deidda M, Pirisi R, Mercuro G. Echocardiographic accidental finding of asymptomatic cardiac and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty. European Heart Journal - Cardiovascular Imaging. 2009;10(4):590–2. DOI: 10.1093/ejechocard/jep030
8. Hodler J, Peck D, Gilula LA. Midterm Outcome after Vertebroplasty: Predictive Value of Technical and Patient-related Factors. Radiology. 2003;227(3):662–8. DOI:10.1148/radiol.2273011930
9. Schmidt R, Cakir B, Mattes T, Wegener M, Puhl W, Richter M. Cement leakage during vertebroplasty: an underestimated problem? European Spine Journal. 2005;14(5):466–73. DOI: 10.1007/s00586-004-0839-5
10. Krueger A, Bliemel C, Zettl R, Ruchholtz S. Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature. European Spine Journal. 2009;18(9):1257–65. DOI: 10.1007/s00586-009-1073-y
11. Baumann A, Tauss J, Baumann G, Tomka M, Hessinger M, Tiesenhausen K. Cement Embolization into the Vena Cava and Pulmonal Arteries After Vertebroplasty: Interdisciplinary Management. European Journal of Vascular and Endovascular Surgery. 2006;31(5):558–61. DOI: 10.1016/j.ejvs.2005.11.008
12. Abdul-Jalil Y, Bartels J, Alberti O, Becker R. Delayed Presentation of Pulmonary Polymethylmethacrylate Emboli After Percutaneous Vertebroplasty: Spine. 2007;32(20):E589–93. DOI:10.1097/BRS.0b013e31814b84ba
13. Barakat AS, Owais T, Alhashash M, Shousha M, El Saghir H, Lauer B et al. Presentation and management of symptomatic central bone cement embolization. European Spine Journal. 2018;27(10):2584–92. DOI: 10.1007/s00586-017-5267-4
14. Elapavaluru S, Alhassan S, Khan F, Khalil R, Schuett A, Bailey S. Severe Acute Traumatic Mitral Regurgitation, Cardiogenic Shock Secondary to Embolized Polymethylmethracrylate Cement Foreign Body After a Percutaneous Vertebroplasty. The Annals of Thoracic Surgery. 2016;101(3):1169–71. DOI: 10.1016/j.athoracsur.2015.04.115
15. Jang JS, Lee SH, Jung SK. Pulmonary Embolism of Polymethylmethacrylate After Percutaneous Vertebroplasty: A Report of Three Cases. Spine. 2002;27(19):E416–8. DOI: 10.1097/00007632-200210010-00021
16. Tozzi P, Abdelmoumene Y, Corno AF, Gersbach PA, Hoogewoud H-M, von Segesser LK. Management of pulmonary embolism during acrylic vertebroplasty. The Annals of Thoracic Surgery. 2002;74(5):1706–8. DOI: 10.1016/S0003-4975(02)03962-0
17. Choe DH, Marom EM, Ahrar K, Truong MT, Madewell JE. Pulmonary Embolism of Polymethyl Methacrylate During Percutaneous Vertebroplasty and Kyphoplasty. American Journal of Roentgenology. 2004;183(4):1097–102. DOI: 10.2214/ajr.183.4.1831097
18. Henderson R. Expert’s comment concerning Grand Rounds case entitled “Intracardiac bone cement embolism as a complication of vertebroplasty: management strategy” by Hatzantonis C, Czyz M, Pyzik R, Boszczyk BM. (Eur Spine J; 2016. doi:10.1007/s00586-016-4695-x). European Spine Journal. 2017;26(12):3206–8. DOI: 10.1007/s00586-017-5089-4
19. Kim YJ, Lee JW, Park KW, Yeom J-S, Jeong HS, Park JM et al. Pulmonary Cement Embolism after Percutaneous Vertebroplasty in Osteoporotic Vertebral Compression Fractures: Incidence, Characteristics, and Risk Factors. Radiology. 2009;251(1):250–9. DOI: 10.1148/radiol.2511080854
20. Cianciulli TF, Mc Loughlin DE, Morita LA, Saccheri MC, Lax JA. Bone cement cardiac and pulmonary embolism. Echocardiography. 2017;34(8):1239–41. DOI: 10.1111/echo.13580
Review
For citations:
Alekhin M.N., Ter-Akopian A.V., Abramov A.S., Skripnikova A.V. Intracardiac and Pulmonary Cement Embolism after Percutaneous Vertebroplasty. Kardiologiia. 2019;59(4):92-96. (In Russ.) https://doi.org/10.18087/cardio.2019.4.10255
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