Cement pulmonary embolism as a complication of percutaneous vertebroplasty in most cancers sufferers.
Most cancers Imaging. 2018 Feb 08;18(1):5
Authors: Mansour A, Abdel-Razeq N, Abuali H, Makoseh M, Shaikh-Salem N, Abushalha Okay, Salah S
BACKGROUND: Vertebroplasty is a minimally invasive process generally carried out for vertebral compression fractures secondary to osteoporosis or malignancy. Leakage of bone cement into the paravertebral venous system and cement pulmonary embolism (cPE) are nicely described, largely in sufferers with osteoporosis. Little is thought concerning the medical sequelae and outcomes in most cancers sufferers. On this examine, we report our expertise with cPE following vertebroplasty carried out in most cancers sufferers.
METHODS: Data of all consecutive most cancers sufferers who underwent vertebroplasty at our establishment have been retrospectively reviewed. The process was carried out through percutaneous injection of barium-opacified polymethyl-methacrylate cement.
RESULTS: A complete of 102 most cancers sufferers with a median age of 53 (19-83) years have been included. Seventy-eight (76.5%) sufferers had malignant vertebral fractures, and 24 (23.5%) sufferers had osteoporotic fractures. Cement PE was detected in 13 (12.7%) sufferers; 10 (76.9%) sufferers had malignant fractures, and the remaining three had osteoporotic fractures. Cement PE was largely asymptomatic; nonetheless, 5 (38.5%) sufferers had respiratory signs that led to the prognosis. Solely the 5 symptomatic sufferers have been anticoagulated. Cement PE was extra widespread with a number of myeloma (MM); it occurred in 7 (18.9%) of the 37 sufferers with MM in contrast with solely three (7.three%) of the 41 sufferers with different malignancies. No distinction in incidence was noticed between sufferers with osteoporotic or malignant vertebral fractures.
CONCLUSIONS: Cement PE is a comparatively widespread complication following vertebroplasty and is usually asymptomatic. A number of myeloma is related to the best threat. Giant-scale potential research may also help establish threat components and medical outcomes and will result in higher prevention and therapeutic methods.
PMID: 29422089 [PubMed – in process]