Severe Pulmonary Embolism was Secondary to Cement Inferior Vena Cava Embolism after Percutaneous Vertebroplasty

Ann Vasc Surg. 2018 Apr:48:255.e1-255.e3. doi: 10.1016/j.avsg.2018.01.003. Epub 2018 Feb 9.

Abstract

Cement pulmonary embolism (cPE) and inferior vena cava embolism (cIE) are rare but potentially life-threatening complications of percutaneous vertebroplasty (PVP). Most cPE and cIE occurred simultaneously. In this case, a 65-year-old woman complained of dyspnea after PVP for 4 days. Patient's symptom and image tests manifest that the cPE was secondary to cIE. Although cIE was found at the first day after PVP, the local surgeons treat the patient with a regular anticoagulant without another more effective therapeutic measure. Eventually, the long cement inferior vena cava embolus was broken and result in left pulmonary embolism via the systemic circulation. She was admitted to our hospital and performed with embolectomy surgery by cardiopulmonary bypass and discharged after 7 days. We report this case to show that cIE embolism is still underestimated by some spine surgeons in China, and cIE may be developed to severe cPE during conservation management with anticoagulation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Cements / adverse effects*
  • Cardiopulmonary Bypass
  • Cementoplasty / adverse effects*
  • Computed Tomography Angiography
  • Embolectomy
  • Embolism / diagnostic imaging
  • Embolism / etiology*
  • Embolism / surgery
  • Female
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / etiology*
  • Foreign-Body Migration / surgery
  • Humans
  • Phlebography / methods
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / etiology*
  • Pulmonary Embolism / surgery
  • Severity of Illness Index
  • Treatment Outcome
  • Vena Cava, Inferior* / diagnostic imaging
  • Vena Cava, Inferior* / surgery

Substances

  • Bone Cements