Cement embolization into the vena cava and pulmonal arteries after vertebroplasty: interdisciplinary management.

Abstract

To report interdisciplinary management in a case of cement embolization into the inferior vena cava and peripheral pulmonary arteries after percutaneous vertebroplasty. A 50-year-old female patient with an osteoporotic compression fracture of the second lumbar vertebra underwent percutaneous vertebroplasty with polymethylmetaacrylate. Thereafter, CT scanning revealed small asymptomatic cement emboli in peripheral pulmonary arteries, along with a hook-shaped cement fragment in the inferior vena cava. Due to the risk that the large cement fragment could migrate to the pulmonary arteries and cause serious complications, they were retrieved from the inferior vena cava by an endovascular technique and extracted through a surgical groin incision. The patient received anticoagulant treatment for 3 months and is free of complaints after 1 year. This case shows that this rare complication following vertebroplasty can be successfully managed with an interdisciplinary approach.