Fatih ATEŞ, Abidin KILINÇER, Hakan CEBECİ, Mehmet Sedat DURMAZ

Radiologic features of pulmonary cement embolism after percutaneous vertebroplasty in a case and review of literature

Percutaneous vertebroplasty is a well-known treatment modality for vertebral compression fractures caused by osteoporosis and malignant metastases. The procedure involves the injection of polymethyl methacrylate (PMMA, bone cement), into the desired vertebral body. Pulmonary cement embolism (PCE) refers to the embolization of PMMA into the pulmonary arteries. Patients are often asymptomatic and it may be detected incidentally for imaging done for another reason. The most common symptoms of pulmonary cement embolization are chest pain and breathlessness, and rarely it can present as acute respiratory distress syndrome. In this case, we aimed to present a 73-year-old male patient of PCE with computed tomography (CT) images. We want to raise the awareness that all patients undergoing vertebroplasty procedure should have routine chest X-ray after the procedure. However, CT is the best modality to determine PCE.

Keywords:

Pulmonary cement embolism, vertebroplasty, CT, polymethyl methacrylate,

PDF

___

Deramond H, Depriester H, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate: Technique, indication, and results. Radiol Clin North Am 1998; 36: 533-46.
Habib N, Maniatis T, Ahmed S, et al. Cement pulmonary embolism after percutaneous vertebroplasty and kyphoplasty: an overview. Heart Lung 2012; 41: 509-11.
Unal E, Balci S, Atceken Z, Akpinar E, Ariyurek OM. Nonthrombotic pulmonary artery embolism: imaging findings and review of the literature. AJR Am J Roentgenol 2017; 208: 505-16.
Ignacio JMF, Ignacio KHD. Pulmonary embolism from cement augmentation of the vertebral body. Asian Spine J 2018; 12: 380-7.
Yuan Z, Zhou Y, Zhou X, et al. Severe pulmonary embolism was secondary to cement inferior vena cava embolism after percutaneous vertebroplasty. Ann Vasc Surg 2018; 48: 255.e1–255.e3.
Mansour A, Abdel-Razeq N, Abuali H, et al. Cement pulmonary embolism as a complication of percutaneous vertebroplasty in cancer patients. Cancer Imaging 2018; 18: 5.
Rahimi B, Boroofeh B, Dinparastisaleh R, Nazifi H. Cement pulmonary embolism after percutaneous vertebroplasty in a patient with cushing's syndrome: A case report. Respir Med Case Rep 2018; 25: 78-85.
Naud R, Guinde J, Astoul P. Pulmonary cement embolism complicating percutaneous kyphoplasty: a case report. Respir Med Case Rep 2020; 31: 101188.
Kim DH, Kim SS, Kim HK. Cement emboli presenting as right atrial mass caused by percutaneous vertebroplasty. Acta Cardiol Sin 2020; 36: 390-3.
Siddiqui A.S, Goodarzi A, Mamjumdar T, et al. A rare case of pulmonary cement embolism in a lung transplant patient. Respir Med Case Rep 2018; 24: 63–4.
Seo JS, Kim YJ, Choi BW, Kim TH, Choe KO. MDCT of pulmonary embolism after percutaneous vertebroplasty. Am J Roentgenol 2005; 184: 1364-5.
Gangi A, Guth S, Imbert JP et-al. Percutaneous vertebroplasty: indications, technique, and results. Radiographics. 2003; 23: e10.