Pulmonary Cement Embolism

Gabe, Luke; Oliva, Isabel

doi:10.1016/j.amjmed.2016.05.025

Cited by 9 publications

(3 citation statements)

References 4 publications

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“…Studies have reported significant variability in the frequency of PCE during this procedure; it ranges from 2-26%. 2 This wide range can be explained by study designs that include screening radiology for all subjects after the procedure or screening only symptomatic subjects. Most PCE are asymptomatic and are incidental findings on chest radiography.…”

Section: Discussionmentioning

confidence: 99%

Cement emboli

Batson¹,

Sigler²

2017

SWRCCC

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CaseThis patient is a 71-year-old woman who presented with persistent chest symptoms. She has a remote history of pulmonary tuberculosis in the 1970s diagnosed by lymph node biopsy and treated with isoniazid and rifampin for an unknown period of time. She has a 20 pack-year smoking history but quit 38 years ago. She worked in the trucking industry and developed a deep venous thrombosis (DVT) in 1991 probably secondary to prolonged trips and was treated with Coumadin for an unknown period of time. In June 2016, she underwent vertebral kyphoplasty. Shortly thereafter, she developed the sudden onset of shortness of breath with dry cough. A V/Q scan was read as an intermediate probability for pulmonary embolus in the right upper lobe. Lower extremity ultrasound studies were negative for DVT at that time. She was started on rivaroxaban and referred for evaluation. She denied dyspnea but stated that she had a sensation of her "chest catching" intermittently. On presentation, her pulse was 91 beats per minute, her respiratory rate was 16 breaths per minute, and her SpO 2 was 97% on room air. Her lungs were clear without adventitious breath sounds. There was no lower extremity edema. Her pulmonary function tests showed normal volumes and mild impairment in diffusion capacity (DLCO 78% predicted, both corrected This figure includes PA and lateral chest x-rays which show calcified densities with a vascular distribution in the upper lung fields. These represent the cement emboli following this patient's vertebroplasty.

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Section: Discussionmentioning

confidence: 99%

Cement emboli

Batson¹,

Sigler²

2017

SWRCCC

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“…5,6,[9][10][11] Similarly, the same high incidence of cement leakage after CAPSI (81.68%) was also found in our inpatients. 5 Cement leakage may lead to serious complications such as nerve root injury, 8 spinal cord compression, 5 pulmonary cement embolism (PCE), 12,13 cardioembolism, 14,15 anaphylactic shock, 16 and even death. 16,17 Among the abovementioned complications, PCE is one of the most severe complications.…”

Section: Neurospine Eissn 2586-6591 Pissn 2586-6583mentioning

confidence: 99%

Risk Factors for Pulmonary Cement Embolism (PCE) After Polymethylmethacrylate Augmentation: Analysis of 32 PCE Cases

et al. 2021

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Objective: Pulmonary cement embolism (PCE) is an underestimated but potentially fatal complication after cement augmentation. Although the treatment and follow-up of PCE have been reported in the literature, the risk factors for PCE are so far less investigated. This study aims to identify the preoperative and intraoperative risk factors for the development of PCE.Methods: A total of 1,373 patients treated with the polymethylmethacrylate (PMMA) augmentation technique were retrospectively included. Patients with PCE were divided into vertebral augmentation group and screw augmentation group. Possible risk factors were collected as follows: age, sex, bone mineral density, body mass index, diagnosis, comorbidity, surgical procedure, type of screw, augmented level, number of augmented vertebrae, fracture severity, presence of intravertebral cleft, cement volume, marked leakage in the paravertebral venous plexus, and periods of surgery. Binary logistic regression analyses were used to analyze independent risk factors for PCE.Results: PCE was identified in 32 patients, with an incidence rate of 2.33% (32 of 1,373). For patients who had undergone vertebral augmentation, marked leakage in the paravertebral venous plexus (odds ratio [OR], 0.012; 95% confidence interval [CI], 0.001–0.103; p = 0.000) and previous surgery (OR, 0.161; 95% CI, 0.042–0.610; p = 0.007) were independent risk factors for PCE. Regarding patients who had undergone screw augmentation, the marked leakage in the paravertebral venous plexus (OR, 0.042; 95% CI, 0.005–0.373; p = 0.004) was the main risk factor.Conclusion: Marked leakage in the paravertebral venous plexus and previous surgery were significant risk factors related to PCE. Paravertebral leakage and operator experience should be concerned when performing PMMA augmentation.

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“…Generally, the common complications of PVP include bone cement leakage, cement embolism, intraoperative puncture injury and new fractures (8)(9)(10)(11). Bone cement leakage and embolism may cause serious adverse complications, such as pulmonary cement embolism (12)(13)(14)(15), spinal compression (16,17), neurological deficit (18,19), atrial mass cement embolism (20), and iatrogenic venous compression (21), which have attracted a lot of attention. However, there are few reports about the hemorrhage caused by vascular injury, although the bleeding may lead to shock or other serious and terrible complications.…”

Section: Introductionmentioning

confidence: 99%

Case report: Shock after percutaneous vertebroplasty of the 5th thoracic vertebra

Hao¹,

Yu²,

Li³

et al. 2023

Front. Surg.

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BackgroundPercutaneous vertebroplasty (PVP) is a common treatment for osteoporotic vertebral compression fracture (OVCF). Perioperative bleeding is usually rare, so there are few reports of shock. However, we developed shock after treating a case of OVCF of the 5th thoracic vertebra with PVP.Case presentationAn 80 years old female patient received PVP due to OVCF of the 5th thoracic vertebra. The operation was successfully completed and the patient returned to the ward safely after the operation. At 90 min after operation, she developed shock, which was induced by subcutaneous hemorrhage up to 1500 ml at the puncture site. Before using vascular embolization, transfusion and blood transfusion were used to maintain blood pressure, and local ice bag compression was used to reduce swelling and stop bleeding, which achieved successful hemostasis. She recovered and discharged after 15 days, with the hematoma having absorbed. There was no recurrence during the 17-month follow-up.ConclusionAlthough PVP is considered to be a safe and effective method to treat OVCF, the possible hemorrhagic shock still needs to arouse the vigilance of surgeons.

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Pulmonary Cement Embolism

Cited by 9 publications

References 4 publications

Cement emboli

Cement emboli

Risk Factors for Pulmonary Cement Embolism (PCE) After Polymethylmethacrylate Augmentation: Analysis of 32 PCE Cases

Case report: Shock after percutaneous vertebroplasty of the 5th thoracic vertebra

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