title: A rare nidus for pulmonary thromboembolism after vertebroplasty.
abstract: Percutaneous vertebroplasty is used to treat osteoporotic compression fractures and bone loss due to malignancy. The cement used can serve as a potential nidus for pulmonary thromboembolism (PTE). An 87-year-old woman with recent L2 vertebroplasty presented with abdominal pain and shortness of breath. Thoracoabdominal CT scan revealed extensive bilateral pulmonary emboli associated with a 9 cm cement fragment in the inferior vena cava (IVC) extending proximally from the level of the right superior renal vein, likely secondary to cement leak from the vertebral plexus into the IVC. She refused catheter extraction was managed conservatively. There are 51 reported cases of cement pulmonary embolism. IVC foreign bodies serving as a nidus for PTE have been reported with IVC filters with an incidence of 6.2%. This is the second reported case of vertebroplasty cement serving as a nidus for PTE. Treatment depends on time interval between the procedure and the symptom onset.
authors.affiliation: Department of Internal Medicine, Alegent-Creighton University Medical Center, Omaha, Nebraska, USA.
authors.forename: Saraschandra
authors.initials: S
authors.lastname: Vallabhajosyula
authors.forename: Pranathi Rao
authors.initials: PR
authors.lastname: Sundaragiri
authors.forename: Ojas
authors.initials: O
authors.lastname: Bansal
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Townley
mesh_terms: D000369:Aged, 80 and over; D001843:Bone Cements / Q000009:adverse effects; D005260:Female; D006801:Humans; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D054854:Vertebroplasty / Q000009:adverse effects*
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate