Abstract Introduction Cement pulmonary embolism (CPE) is an uncommon but recognized complication following vertebral augmentation procedures such as vertebroplasty or kyphoplasty. It results from cement leakage into the venous system and subsequent embolization to the lungs. This diagnosis consists of a radiographically detected emboli occurring in approximately 4% to 26% of cases—most of which are asymptomatic. Symptomatic cases are much less common, affecting less than 1% to 4% of patients. Careful injection technique and postoperative imaging help reduce the risk and detect complications early. Case Presentation 69-year-old woman with medical history of Chronic Obstructive Pulmonary Disease (COPD), hypertension, psoriasis, and osteoporosis. She was previously diagnosed with an osteoporotic compression fracture, for which she underwent percutaneous vertebroplasty one year ago without immediate complications. She was in her normal state until she began experiencing progressive dyspnea, chest discomfort, and episodes of hypoxia. Her clinical picture became concerning, prompting further evaluation. During her hospital admission, she presented acutely with worsening shortness of breath, altered mental status, and chest discomfort—signs suggestive of a cardiopulmonary compromise. Given her recent history and persistent symptoms, a chest CT angiography was performed, revealing hyper densities, cement emboli lodged within segmental pulmonary arteries—a complication of her prior vertebroplasty. Troponin 80 ng/L and BNP 275 pg/mL and Echocardiography reports concentric hypertrophy with preserved left ventricular ejection fraction. After diagnosis, dual oral anticoagulation with apixaban was given and three-month follow up for monitoring symptoms. Discussion Cement leakage occurs when polymethylmethacrylate (PMMA) extravasates into vertebral veins. Embolization typically remains asymptomatic but can cause respiratory symptoms, hypoxia, or rare complications like infarction. Symptomatic cement pulmonary embolism is much rarer, with reported incidences ranging from less than 1% to around 4%. Diagnosis relies on imaging—CT is preferred for identifying radiopaque cement emboli. Management varies from observation in asymptomatic cases to anticoagulation or surgical intervention if symptomatic. Conclusion Cement pulmonary embolism is an uncommon but important consideration in vertebroplasty, with a notable percentage of asymptomatic cases detected through imaging, underscoring the need for careful technique and follow-up. Clinicians should be aware of the potential for cement embolism following vertebral augmentation. Proper technique and vigilant postoperative monitoring are essential to minimize risks and ensure prompt diagnosis and management if complications arise. This abstract is funded by: None
Caro et al. (Fri,) studied this question.