J Korean Med Sci.  2018 May;33(19):e141. 10.3346/jkms.2018.33.e141.

Intra-cardiac Embolism of a Large Bone Cement Material after Percutaneous Vertebroplasty Removed through a Combination of an Endovascular Procedure and an Inferior Vena Cava Exploration: a Case Report

• Park JS
• Kim J
• Lee Y
• Gwon JG
• Park YS

• KMID: 2410526
• DOI: http://doi.org/10.3346/jkms.2018.33.e141

Abstract

Percutaneous vertebroplasty (PVP) is a minimally invasive surgical treatment for patients with osteoporotic vertebral compression fracture (OVCF) and can rapidly alleviate pain, improve mobility, and stabilize the vertebrae. However, it has the potential to cause complications such as cement embolism. A 55-year-old female presented with pain in the lumbar region as a chief complaint. PVP was performed after diagnosis of acute OVCFs at L4 and L5. No abnormal symptoms were reported after surgery, but a large cement embolism was observed in her right atrium and ventricle. After discussion in a multi-disciplinary team, the large cement embolism was successfully removed by a combination of endovascular procedure and an inferior vena cava exploration. Surgeons must consider the possibility of intra-cardiac cement embolism after PVP. A hybrid approach of an endovascular procedure and a vascular surgery may be a reasonable treatment option to minimize the surgical procedure in cases of a large intra-cardiac cement embolism.

Keyword

Vertebroplasty; Embolism; Endovascular Procedures; Inferior Vena Cava

MeSH Terms

Diagnosis
Embolism*
Endovascular Procedures*
Female
Fractures, Compression
Heart Atria
Humans
Lumbosacral Region
Middle Aged
Spine
Surgeons
Vena Cava, Inferior*
Vertebroplasty*