J Lipid Atheroscler.  2015 Dec;4(2):141-144. 10.12997/jla.2015.4.2.141.

Intramural Hematoma with Air Density on Computed Tomography after Percutaneous Kyphoplasty

• Woo JY
• Moon SY
• Park HS
• Kim KU
• Choi JK
• Seo WW
• Park DG

• KMID: 2151823
• DOI: http://doi.org/10.12997/jla.2015.4.2.141

Abstract

Iatrogenic aortic dissection occurs in association with diverse invasive procedures. It occurs primarily as a complication of cardiac surgery or after catheterization procedure. We found a case of iatrogenic abdominal aortic dissection caused by traumatic needle injury. The patient complained of abdominal pain after balloon kyphoplasty. Abdominal computed tomography (CT) showed intramural hematoma with air density suggestive of an iatrogenic cause. The patient was managed conservatively, and no lesion progression was noted in the follow-up CT. To the best of our knowledge, this is the first case of iatrogenic aortic dissection associated with kyphoplasty.

Keyword

Aortic dissection; Intramural hematoma; Kyphoplasty

MeSH Terms

Abdominal Pain
Catheterization
Catheters
Follow-Up Studies
Hematoma*
Humans
Kyphoplasty*
Needles
Thoracic Surgery

Figure

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  Fig. 1 Angiographic CT showed pulmonary thromboembolism in the right main, lobar pulmonary artery (white arrow).

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  Fig. 2 (A) Enhanced abdominal computed tomography in the sagittal plane performed in the emergency room showed cement masses within the T12 vertebral body (white arrow). Aortic dissection with thrombus formation in the pseudolumen at the T12-L2 vertebral level was observed. An air bubble can be seen in the thrombus (white arrowhead), (B) Axial view at the level of the air bubble(white arrow), (C) A zoomed-in photograph of the air bubble in the thrombus (white arrow).

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  Fig. 3 A sagittal view of the spine before kyphoplasty. T2-weighted magnetic resonance imaging showing a T12 vertebral compression fracture (white arrow). Normal aortic structure can be seen at the same level.

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