Vertebroplasty-associated cement leak leading to iatrogenic venous compression and thrombosis

Nezami, Nariman; Jarmakani, Haddy; Latich, Igor; Groenwald, M.; Lozada, Juan Carlos Perez

doi:10.1016/j.jvscit.2019.08.009

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…6 Nezami et al described a patient who developed PCD as a result of vertebroplasty-associated cement leakage, and was treated with PT. 7 Another case report presented a patient who developed PCD due to an external compression of the iliofemoral venous axis by a hematoma which resulted from shearing of a sacral screw placed during a spinal fusion surgery. 8 Our analysis revealed that three patients developed PCD following a spinal surgery which raises a concern whether vertebral instrumentation and spinal fusion surgeries can carry the risk of direct external compression of the iliofemoral venous axis, placing these individuals at a high risk for developing fulminant DVT's that have the potential for progressing to PCD.…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis of the efficacy and safety of therapeutic interventions in phlegmasia cerulea dolens

2020

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Objective Present an institution’s experience in management of phlegmasia cerulea dolens (PCD) with a review of the literature. Methods Beaumont Health’s electronic record database was queried between July 2009 and November 2019 for inpatients with PCD. A comprehensive chart review was performed to verify the accuracy of the diagnosis and extract relevant parameters. Medians and proportions are reported. Results 22 patients met the criteria for PCD. 59% females. Median age 65 years (interquartile range [IQR] 22). Obesity was present in 45% of patients. 18 patients underwent either a single modality (55.5%) or a multimodality therapeutic approach (44.5%). Limb amputation was required in a third of patients who underwent catheter-directed thrombolysis or percutaneous thrombectomy alone. Death was highest after percutaneous thrombectomy alone (66%) followed by pharmacomechanical catheter-directed thrombolysis alone (50%). Conclusion Percutaneous interventions have become the mainstay in management of PCD as demonstrated in this large retrospective analysis and supported by literature review.

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Section: Discussionmentioning

confidence: 99%

A comparative analysis of the efficacy and safety of therapeutic interventions in phlegmasia cerulea dolens

2020

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“…The literature also described a few more cases where the ClotTriever system was successfully used for DVT. In one case study, it was used as an adjunct to CDT [ 6 ], and in two other cases, it was used as the sole treatment, one for a patient with extensive DVT [ 7 ] and another for a patient with PCD [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed Yet Successful Mechanical Thrombectomy for Phlegmasia Cerulea Dolens in a Limb with Severe Arterial Disease and May-Thurner Syndrome

Said

Kraft

Sayed

2020

Case Reports in Vascular Medicine

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Phlegmasia cerulea dolens (PCD) is a rare but life-threatening complication of acute deep venous thrombosis that lacks consensus regarding the approach to management. We present a case of PCD developing shortly after a spinal surgery and manifesting as acute swelling and discoloration in a leg with existing severe atherosclerotic arterial disease. The patient’s critical limb ischemia was completely and rapidly reversed by percutaneous mechanical thrombectomy using the ClotTriever device despite a delay in treatment. An underlying iliac vein compression “May-Thurner” syndrome was discovered using intravascular ultrasound and treated with angioplasty. This case identifies mechanical thrombectomy using the ClotTriever system as a possible effective and safe treatment for PCD.

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“…Generally, the common complications of PVP include bone cement leakage, cement embolism, intraoperative puncture injury and new fractures ( 8 – 11 ). Bone cement leakage and embolism may cause serious adverse complications, such as pulmonary cement embolism ( 12 – 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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Vertebroplasty-associated cement leak leading to iatrogenic venous compression and thrombosis

Cited by 6 publications

References 12 publications

A comparative analysis of the efficacy and safety of therapeutic interventions in phlegmasia cerulea dolens

A comparative analysis of the efficacy and safety of therapeutic interventions in phlegmasia cerulea dolens

Delayed Yet Successful Mechanical Thrombectomy for Phlegmasia Cerulea Dolens in a Limb with Severe Arterial Disease and May-Thurner Syndrome

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

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