Table 1.
Case reports of pulmonary cement embolism (PCE) after vertebral augmentation in retrieved literature
| Author/Publication date | Operation level and operation indication | Clinical manifestation | When manifestation presented/when PE was detected | Cement migration | Management | Outcome |
|---|---|---|---|---|---|---|
| Tozzi et al.23 (2002) | T11 fracture (PVP) | Developed respiratory distress, renal failure, a mean pulmonary artery pressure of 48 mm Hg, right cardiac failure | At the end of the PVP procedure | Perivertebral venous system, IVC, both Pas | Noninvasive ventilatory support, inotropic agents, heparin, pulmonary embolectomy | Recovered from respiratory and cardiac failure |
| Jang et al.48 (2002) | T6, T9, T10, T11, L1, L2 CF (PVP) | Chemical odor of solvent in the patient's mouth and nausea, mild dyspnea, chest discomfort | During cement injection | PA | Delayed injection, oxygen inhalation and anticoagulants | Dyspnea regressed |
| Katrien et al.43 (2003) | T11 CF (PVP) | Mild dyspnea, reduced blood flow to the right lower lobe | 2 days after the procedure | Right PA | Intravenous heparin, catheter procedure and open‐heart operation, oral anticoagulant therapy | Uneventful recovery |
| Bernhard et al.51 (2003) | T10, 11, L1 CFs (PVP) | Denied any respiratory symptoms | 6 months later | Both lungs | — | Discharged |
| Kim et al.24 (2005) | T8 fracture (PVP) | Severe chest pain, hemopericardium, cardiac perforation | 7 days after the PVP | Azygous vein, RA and RV, PA | Open heart surgery for hemopericardium and cement removal | Discharged |
| Seo et al.57 (2005) | L1, 2 CFs (PVP) | Palpable mass on the subareolar of the left chest wall | 2 years after the PVP | IVC, RA, right PA | Right atriotomy and inferior vena cavotomy | — |
| Chung et al.29 (2006) | L1 CF (PVP) | Impaired renal function | During operation | Both renal vessels | Treated conservatively | Discharged with BUN to Cr returned to normal |
| Freitag et al.49 (2006) | L1‐L5 OVCFs (PVP) | A sudden onset of arrhythmia, hypotension (BP, 65/30 mm Hg), oxygen desaturation (SpO2, 91%) | During cement injection | Left inferior lobe PA | Stopped injection, intravenous unfractionated high‐dose heparin, further observation in ICU | Discharged on oral anticoagulant |
| Abdul et al.42 (2007) | T11, 12 OVCFs (PVP) | Dyspnea, chest pain, increased D‐dimers level, ventilation‐perfusion mismatch | 3 days after discharge | Paravertebral venous system, both lungs | Low‐molecular‐weight heparin, Enoxaparin and Anti‐Xa | Rapid resolution of dyspnea and chest pain |
| Lim et al.25 (2007) | L2, 5 CF (PVP) | Mild dyspnea and edema lasting 4 weeks, ventilation‐perfusion mismatch | 5 years after the procedure | IVC, right hepatic vein, RA, left PA | Anticoagulation, open‐heart surgery for atrial thrombectomy | An uneventful recovery |
| Lim et al.45 (2008) | T12, L1 CF (PVP) | Chest pain, dyspnea, cardiac perforation, pericardial effusion | 2 months after T12 PVP and 9 days after L1 PVP | Right upper lung and RV | Pericardial collection aspiration, cement removal, repair of right ventricular wall | Experienced no sequelae |
| Son et al.26 (2008) | L1, 2, 4 CF (PVP) | Chest pain and tightness, hemopericardium, severe tricuspid regurgitation, cardiac tamponade | 5 days after the procedure | ICV, RV | Emergent operation for cement removal and suture of perforated right ventricle, tricuspid annuloplasty | Recovery without any complication and discharged |
| Cadeddu et al.52 (2009) | T12, L2 OVCFs (PVP) | Asymptomatic | 2 years after the procedure | RA and RV, left PA | Right cardiac catheterism | Failed removal of cement |
| Braiteh et al.44 (2009) | L3 CF (PVP) | Intermittent precordial chest pain and palpitation | 5 months after the operation | RA and RV | Endovascular procedure for foreign body retrieve | Symptoms relieved |
| Caynak et al.46 (2009) | T4, 9 CF (PVP) | Progressive dyspnea, chest discomfort, hemodynamic unstability, cardiac tamponade by pericardial collection | 2 months after operation | Azygous veins, both PAs, RA and RV | Anticoagulation, pulmonary physiotherapy, emergent operation for hemorrhagic fluid drain and cement particles removal | Favorable outcome |
| Radcliff et al.60 (2010) | L2 CF (PKP) | Shortness of breath symptoms with productive cough | 28 days after PKP | Right PA | Conservative management | Discharged with no further exacerbation |
BUN, blood urea nitrogen; CF, compression fracture; IVC, inferior vena cava; OVCF, osteoporotic vertebral compression fracture; PA, pulmonary artery; PVP, percutaneous vertebroplasty; RA, right atrium; RV, right ventricle.