Thorac Cardiovasc Surg 2010; 58(7): 437-439
DOI: 10.1055/s-0029-1240847
Case Reports

© Georg Thieme Verlag KG Stuttgart · New York

Pulmonary Palacos Embolism: A Case Report

A. Rasch1 , J. Sindermann1 , H. H. Scheld1 , A. Hoffmeier1
  • 1Department of Thoracic and Cardiovascular Surgery, University Hospital, Westfälische Wilhelms-University, Münster, Germany
Further Information

Publication History

received October 11, 2009

Publication Date:
04 October 2010 (online)

Abstract

Instrumentation with cement-augmented pedicle screws has expanded the therapeutic spectrum. This technique is useful for the palliation of bone metastases and in generalized osteoporosis. Serious complications such as pulmonary embolism have been described following percutaneous vertebroplasty, a frequently used technique. We report the case of a 55-year-old patient with a large central Palacos embolism of the right pulmonary artery after corporectomy of the lumbar vertebrae 3 and 4 and reconstruction using autologous pelvic bone. The large Palacos embolism was removed successfully from the right pulmonary artery with extracorporeal circulation.

References

  • 1 Tan J S, Singh S, Zhu Q A, Dvorak M F, Fisher C G, Oxland T R. The effect of cement augmentation and extension of posterior instrumentation on stabilization and adjacent level effects in the elderly spine.  Spine. 2008;  33 (25) 2728-2740
  • 2 Blattert T R, Glasmacher S, Riesner H J, Josten C. Revision characteristics of cement-augmented, cannulated-fenestrated pedicle screws in the osteoporotic vertebral body: a biomechanical in vitro investigation. Technical note.  J Neurosurg. 2009;  11 (1) 23-27
  • 3 Padovani B, Kasriel O, Brunner P, Peretti-Viton P. Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty.  AJNR. 1999;  20 (3) 375-377
  • 4 Jang J S, Lee S H, Jung S K. Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: a report of three cases.  Spine. 2002;  27 (19) E416-E418
  • 5 Abdul-Jalil Y, Bartels J, Alberti O, Becker R. Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty.  Spine. 2007;  32 (20) E589-E593
  • 6 Freitag M, Gottschalk A, Schuster M, Wenk W, Wiesner L, Standl T G. Pulmonary embolism caused by polymethylmethacrylate during percutaneous vertebroplasty in orthopaedic surgery.  Acta Anaesthesiol Scand. 2006;  50 (2) 248-251
  • 7 Bonardel G, Pouit B, Gontier E, Dutertre G, Mantzarides M, Goasguen O et al. Pulmonary cement embolism after percutaneous vertebroplasty: a rare and nonthrombotic cause of pulmonary embolism.  Clin Nucl Med. 2007;  32 (8) 603-606
  • 8 Leidinger W, Hoffmann G, Meierhofer J N, Wolfel R. [Reduction of severe cardiac complications during implantation of cemented total hip endoprostheses in femoral neck fractures].  Unfallchirurg. 2002;  105 (8) 675-679
  • 9 Zaccheo M V, Rowane J E, Costello E M. Acute respiratory failure associated with polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty.  Am J Emerg Med. 2008;  26 (5) 636-(e5–e7)
  • 10 Urbanyi B, Hauck P, Matthias K, Bohm N, Schlosser V. [Experimental investigations into artery injury due to bone cement (author's transl)].  Langenbecks Arch Chir. 1978;  346 (1) 47-52
  • 11 Pearl J M, Wellmann S A, McNamara J L, Lombardi J P, Wagner C J, Raake J L et al. Bosentan prevents hypoxia-reoxygenation-induced pulmonary hypertension and improves pulmonary function.  Ann Thorac Surg. 1999;  68 (5) 1714-1722
  • 12 Galie N, Ghofrani H A, Torbicki A, Barst R J, Rubin L J, Badesch D et al. Sildenafil citrate therapy for pulmonary arterial hypertension.  New Engl J Med. 2005;  353 (20) 2148-2157
  • 13 Hoeper M M, Faulenbach C, Golpon H, Winkler J, Welte T, Niedermeyer J. Combination therapy with bosentan and sildenafil in idiopathic pulmonary arterial hypertension.  Eur Respir J. 2004;  24 (6) 1007-1010

Andreas Hoffmeier, M.D.

Department of Thoracic and Cardiovascular Surgery
University Hospital, Westfälishe Wilhelms-University

Albert-Schweitzer-Str. 33

48149 Münster

Germany

Phone: +49 25 18 34 74 01

Fax: +49 25 18 34 83 16

Email: andreas.hoffmeier@ukmuenster.de

    >