Cement embolization into the vena cava and pulmonal arteries after vertebroplasty: Interdisciplinary management

Purpose. To report interdisciplinary management in a case of cement embolization in to the inferior vena cava and peripheral pulmonary arteries after percutaneous vertebroplasty. Case report. A 50-year-old female patient with air osteoporotic compression fracture of tire second lumbar vertebra underwent percutaneous vertebroplasty with polymethylmetnacrylate. Thereafter, CT scanning revealed small asymptomatic cement emboli in peripheral pulmonary arteries, along with a hook-shaped cement fragment in the inferior vena cava. Due to the risk that the large cement fragment could migrate to the pulmonary arteries and cause serious complications, they were retrieved from the inferior vena cava by air endovascular technique and extracted through a surgical groin incision. The patient received anticoagulant treatment for 3 months and is free of complaints after 1 year. Conclusion. This case shows that this rare complication following vertebroplasty can be successfully managed with all interdisciplinary approach.