Acute respiratory failure associated with polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty.
We report a case of symptomatic polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty to alert clinicians to this potential cause of pulmonary emboli. A 77-year-old woman developed acute respiratory failure after multilevel percutaneous vertebroplasty. She received mechanical ventilatory support and anticoagulation with low-molecular-weight heparin and warfarin. Multiple pulmonary polymethyl methacrylate cement emboli were identified by computed tomography angiogram. Polymethyl methacrylate cement extravasation into the vertebral venous circulation is common during vertebroplasty. Pulmonary embolism caused by cement migration after this procedure is extremely rare, as reported in the literature to date. However, the frequency of this complication may increase secondary to the widespread use of percutaneous vertebroplasty and kyphoplasty for osteoporotic compression fractures.
Division of Hospitalist Medicine/Pulmonary and Critical Care Medicine, Hamot Medical Center Erie, PA 16550, USA. mmzaccheo@yahoo.com
Matthew V
MV
Zaccheo
Joseph E
JE
Rowane
Erin M
EM
Costello
D000208:Acute Disease; D000368:Aged; D001843:Bone Cements; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications*; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D012131:Respiratory Insufficiency / Q000209:etiology*; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D054854:Vertebroplasty / Q000009:adverse effects*
D001843:Bone Cements; D019904:Polymethyl Methacrylate