Successful Percutaneous Retrieval of a Large Pulmonary Cement Embolus Caused by Cement Leakage During Percutaneous Vertebroplasty

Zhao, Yuan-Ting; Liu, Tuan-Jiang; Zheng, Ya; Wang, Liping; Hao, Dingjun

doi:10.1097/brs.0000000000000613

Cited by 24 publications

(17 citation statements)

References 37 publications

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“…It is well known that bone cement leakage may occur in PVP and PKP treatment. The bone cement leakage may lead to pulmonary embolism [ 15 – 17 ], neurological deficit [ 18 ], and even paraplegia [ 19 ]. This work showed PMMA leakage occurred in 6.67% patients treated by PVP, 3.33% patients treated by PKP, and none of patients treated by PMCP ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy Studies of Vertebroplasty, Kyphoplasty, and Mesh-Container-Plasty for the Treatment of Vertebral Compression Fractures: Preliminary Report

Chen

Li²,

Wang

et al. 2016

PLoS ONE

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To evaluate the clinical safety and efficacies of percutaneous vertebroplasty (PVP), percutaneous kyphoplasty (PKP), and percutaneous mesh-container-plasty (PMCP) for the treatment of vertebral compression fractures (VCFs), a retrospective study of 90 patients with VCFs who had been treated by PVP (n = 30), PKP (n = 30), and PMCP (n = 30) was conducted. The clinical efficacies of these three treatments were evaluated by comparing their PMMA cement leakages, cement patterns, height restoration percentages, wedge angles, visual analogue scales (VAS), and oswestry disability index (ODI) at the pre- and post-operative time points. 6.67%, 3.33%, and 0% of patients had PMMA leakage in PVP, PKP, and PMCP groups, respectively. Three (solid, trabecular, and mixed patterns), two (solid and mixed patterns), and one (mixed patterns) types of cement patterns were observed in PVP, PKP, and PMCP groups, respectively. PKP and PMCP treatments had better height restoration ability than PVP treatment. PVP, PKP, and PMCP treatments had significant and similar ability in pain relief and functional recovery ability for the treatment of VCFs. These results indicate minimally invasive techniques were effective methods for the treatment of VCFs. Moreover, these initial outcomes suggest PMCP treatment may be better than both PVP treatment and PKP treatment.

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Section: Discussionmentioning

confidence: 99%

Safety and Efficacy Studies of Vertebroplasty, Kyphoplasty, and Mesh-Container-Plasty for the Treatment of Vertebral Compression Fractures: Preliminary Report

Chen

Li²,

Wang

et al. 2016

PLoS ONE

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“…Recently, calcium phosphate cement has replaced PMMA because it is a self-hardening material, without the need for local heating, and is nontoxic to surrounding bone tissue 10) . However, both of them have some disadvantages, including epidural leakage, subdural hematoma, pulmonary embolism, and adjacent vertebral fractures [12][13][14] . Although artificial bones, including HA blocks, are osteoconductive and can provide stability, they are not osteoinductive and remain as foreign materials because of the low absorption rate 22) .…”

Section: Discussionmentioning

confidence: 99%

“…There are several vertebroplasty materials available, such as polymethyl methacrylate (PMMA) bone cement 9) , calcium phosphate cement 5,10) , hydroxyapatite (HA) blocks 5,7) , and autologous bone 11) , but the optimal material remains controversial. Cement has a risk of embolism and nerve damage 12,13) , and its stiffness can cause incident fracture at the adjacent level 14) . Autologous bone grafting has disadvantages such as donor-site pain, infection, and prolonged operative time 11) .…”

Section: Introductionmentioning

confidence: 99%

Vertebroplasty Using Allograft Bone Chips with Posterior Instrumented Fusion in the Treatment of Osteoporotic Vertebral Fractures with Neurological Deficits

Masuda

Onishi

Ota

et al. 2019

Spine Surg Relat Res

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Introduction: In general, osteoporotic vertebral fractures with neurological deficits require surgery. However, the ideal surgical method remains controversial. We evaluated the efficacy of combining posterior instrumented fusion and vertebroplasty using allograft bone chips. Methods: Twelve patients (five men, seven women; age 68-84 years, mean age 75.9 years) with osteoporotic vertebral fractures with neurological deficits were reviewed retrospectively. They underwent posterior instrumented fusion and vertebroplasty, using allograft bone, at our institution between January 2007 and June 2016. We assessed the surgical results, radiologically and neurologically, after a mean follow-up of 37.3 months. Results: The mean local kyphosis angle was 10°before surgery, −3.3°immediately after surgery, and 4.4°at follow-up. The average spinal canal compromise was 26.9% before surgery and 19.5% at follow-up. All patients achieved bony fusion and none needed additional surgery. All patients improved by at least one grade on the modified Frankel grading system. Conclusions: Combining vertebroplasty, using allograft bone chips, and posterior instrumented fusion appears to be an effective option for osteoporotic vertebral fractures with neurological deficits.

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“…45 The degree of vascular compromise guides treatment decision between systemic anticoagulation and retrieval by endovascular or open surgical methods. 40,[46][47][48] Intra-arterial cement extrusion is a rare but potentially serious complication. An arterial embolus during vertebral augmentation may migrate into the aorta and result in distal emboli into the mesenteric, renal, or lower extremities (►Fig.…”

Section: Periosteal Cement Extrusionmentioning

confidence: 99%

Percutaneous Cement Injection for the Palliative Treatment of Osseous Metastases: A Technical Review

Yevich

Tselikas

Gravel

et al. 2018

Semin intervent Radiol

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The technical art to percutaneous injection of polymethyl methacrylate (PMMA) cement for the palliative treatment of osseous metastases is not without pitfalls. Pathologic fracture, cortical bone erosion, large lytic tumor, aggressive tumor biology, and tumor vascularity may increase the risk of cement leakage or limit complete consolidation. A calculated and determined approach is often necessary to achieve satisfactory patient-tailored results. This article reviews the challenges and potential complications during the consolidation of osseous metastases. Case examples are presented to facilitate early detection of impending cement leakage, minimize procedural risks, and provide management suggestions for complications. Technical pearls are provided to refine consolidative techniques and improve the comprehensive treatment of painful osseous metastases.

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Successful Percutaneous Retrieval of a Large Pulmonary Cement Embolus Caused by Cement Leakage During Percutaneous Vertebroplasty

Abstract: N/A.

Cited by 24 publications

References 37 publications

Safety and Efficacy Studies of Vertebroplasty, Kyphoplasty, and Mesh-Container-Plasty for the Treatment of Vertebral Compression Fractures: Preliminary Report

Safety and Efficacy Studies of Vertebroplasty, Kyphoplasty, and Mesh-Container-Plasty for the Treatment of Vertebral Compression Fractures: Preliminary Report

Vertebroplasty Using Allograft Bone Chips with Posterior Instrumented Fusion in the Treatment of Osteoporotic Vertebral Fractures with Neurological Deficits

Percutaneous Cement Injection for the Palliative Treatment of Osseous Metastases: A Technical Review

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