Document Detail


Cardiovascular changes after pulmonary cement embolism: an experimental study in sheep.
MedLine Citation:
PMID:  17569954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Most cement leaks during vertebroplasty are asymptomatic, but pulmonary cement embolism has been reported to cause cardiovascular disturbances and even death. Adding hydroxyapatite (HA) to polymethylmethacrylate (PMMA) cement to reduce the quantity of barium may aggravate cardiovascular deterioration in the event of cement embolism by activating coagulation. Thus, we investigated the cardiovascular changes after pulmonary cement embolism of PMMA with and without HA. MATERIALS AND METHODS: In 13 sheep, cement (2.0 mL) was injected into the pulmonary trunk. Two different cements were used: 1) standard PMMA and 2) PMMA with 10% HA (PMMA & HA). Arterial, central venous and pulmonary arterial pressures, heart rate, and cardiac output were monitored continuously until 60 minutes after the injection. Blood gases and coagulation parameters (antithrombin, D-dimer) were measured before and after injection. RESULTS: Mean pulmonary arterial pressure had increased by approximately 9% (PMMA) and 14% (PMMA & HA) 1 minute after injection and stayed elevated. There were no significant differences between the groups. No evidence of thromboembolism was detected. CONCLUSION: Cement embolism did not result in clinically significant pulmonary arterial hypertension. Adding HA to PMMA cement did not cause more severe cardiovascular changes.
Authors:
J Krebs; N Aebli; B G Goss; K Wilson; R Williams; S J Ferguson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  28     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:    2007 Jun-Jul
Date Detail:
Created Date:  2007-06-15     Completed Date:  2007-08-08     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1046-50     Citation Subset:  IM    
Affiliation:
MEM Research Center, Institute for Surgical Technology and Biomechanics, Medical Faculty, University of Bern, Switzerland. jorg.krebs@memcenter.unibe.ch
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure
Drug Combinations
Durapatite / adverse effects*
Extravasation of Diagnostic and Therapeutic Materials / complications*,  physiopathology*
Female
Heart / physiopathology*
Heart Rate
Methylmethacrylates / adverse effects*
Pulmonary Embolism / etiology*,  physiopathology*
Sheep
Chemical
Reg. No./Substance:
0/Drug Combinations; 0/Methylmethacrylates; 0/vertebroplastic; 1306-06-5/Durapatite

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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