Document Detail


Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures: incidence, characteristics, and risk factors.
MedLine Citation:
PMID:  19332856     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To prospectively evaluate the incidence of, characteristics of, and risk factors for pulmonary cement embolism after percutaneous vertebroplasty (PVP) in osteoporotic vertebral compression fractures (VCFs). MATERIALS AND METHODS: Institutional review board approval and written informed consent were obtained. From June 2006 to September 2007, 75 patients (57 women, 18 men; mean age, 74.78 years; range, 48-93 years) who underwent 78 PVP sessions at 119 levels for osteoporotic VCFs were prospectively enrolled in this study. Computed tomographic (CT) scans of the chest and treated vertebrae were obtained after PVP. The presence, location, involved pulmonary arteries, number, and size of each pulmonary cement embolus were analyzed at CT. Possible risk factors were analyzed as follows: Age, injected cement volumes, and numbers of treated vertebrae were analyzed by using the Mann-Whitney U test; operators (radiologist or nonradiologist), level of treated vertebrae, guidance equipment, approach (uni- or bipedicular), presence of intravertebral vacuum clefts, and presence of paravertebral venous leakage were analyzed by using Pearson chi(2) and Fisher exact tests. RESULTS: Pulmonary cement emboli developed in 18 (23%) of 78 PVP sessions and were detected in the distal to third-order pulmonary arteries. Only cement leakage into the inferior vena cava showed a statistically significant relationship to pulmonary cement embolism (P = .03). A higher frequency of pulmonary cement embolism was noted for the absence of intravertebral vacuum clefts, for the bipedicular approach, and for a nonradiologist operator with C-arm fluoroscopy (P > .05). CONCLUSION: In osteoporotic VCFs, pulmonary cement embolism was detected in 23% of PVP sessions, developed in the distal to third-order pulmonary arteries, and was related to leakage into the inferior vena cava.
Authors:
Yeo Ju Kim; Joon Woo Lee; Kun Woo Park; Jin-Seob Yeom; Hee Sun Jeong; Jeong Mi Park; Heung Sik Kang
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Radiology     Volume:  251     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  250-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeongi-do 463-707, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bone Cements / therapeutic use
Causality
Comorbidity
Female
Fractures, Compression / epidemiology*,  therapy*
Humans
Incidence
Korea / epidemiology
Male
Middle Aged
Osteoporosis / epidemiology*,  therapy*
Pulmonary Embolism / epidemiology*
Risk Assessment / methods
Risk Factors
Spinal Fractures / epidemiology*,  therapy*
Vertebroplasty / statistics & numerical data*
Chemical
Reg. No./Substance:
0/Bone Cements

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