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Case Reports
. 2018 Jun 27:25:78-85.
doi: 10.1016/j.rmcr.2018.06.009. eCollection 2018.

Cement pulmonary embolism after percutaneous vertebroplasty in a patient with cushing's syndrome: A case report

Besharat Rahimi  1 , Behdad Boroofeh  1 , Roshan Dinparastisaleh  2 , Hale Nazifi  2
Affiliations
Case Reports

Cement pulmonary embolism after percutaneous vertebroplasty in a patient with cushing's syndrome: A case report

Besharat Rahimi et al. Respir Med Case Rep. .

Abstract

Background: Vertebroplasty is a procedure most commonly used for vertebral compression fractures. Although it is a relatively safe procedure, complications have been reported. Cement embolism is seen in 2.1%-26% of patients after percutaneous vertebroplasty.

Case presentation: a 38-year-old male who was diagnosed with cushing's syndrome, underwent percutaneous vertebroplasty for his thoracic osteoporotic compression fractures. 24-hours following vertebroplasty, he presented to emergency department with acute-onset dyspnea and chest pain. Chest radiography showed an opaque linear lesion in left pulmonary artery which was suggestive of cement embolism. Pulmonary spiral CT-scan further confirmed the diagnosis. The patient's symptoms improved over time, and warfarin was started with close cardiopulmonary assessments for indicators of cement embolus removal.

Conclusion: in patients with pulmonary cement embolism, conservative treatment may be recommended rather than a surgical removal except when the obstruction is extensive enough to cause hemodynamic changes. Given that all the related studies have suggested that pulmonary thromboembolism can occur as a complication due to bone cement leakage, discovering new cement alternatives and/or injection devices, seems beneficial.

Keywords: Cement embolism; Complications; Percutaneous vertebroplasty; cushing's syndrome.

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Figures

Fig. 1
Fig. 1
Chest X-ray showing linear opaque lesion in left pulmonary artery.
Fig. 2
Fig. 2
Hyperdense lesion on left pulmonary artery.
Fig. 3
Fig. 3
Hyperdense lesion on main pulmonary artery and left pulmonary artery.
See this image and copyright information in PMC

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