Cement Embolization of a Segmental Artery after Percutaneous Vertebroplasty: A Potentially Catastrophic Vascular Complication

• Published in: Interventional neuroradiology Vol. 18; no. 3; pp. 358 - 362
• Main Authors: Matouk, C.C., Krings, T., Ter Brugge, K.G., Smith, R.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-09-2012; Centauro S.r.l
• Subjects: Aged, 80 and over; Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - etiology; Bone Cements - adverse effects; Embolism, Paradoxical - diagnosis; Embolism, Paradoxical - etiology; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Magnetic Resonance Imaging; Original; Osteoporotic Fractures - surgery; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Spinal Fractures - surgery; Tomography, X-Ray Computed; Vertebroplasty; artery of Adamkiewicz; vascular complications; vertebroplasty; cement embolization
• ISSN: 1591-0199; 2385-2011
• DOI: 10.1177/159101991201800318

Serious complications related to percutaneous vertebral augmentation procedures, vertebroplasty and kyphoplasty, are rare and most often result from local cement leakage or venous embolization. We describe an adult patient who underwent multi-level, thoracic percutaneous vertebral augmentation procedures for painful osteoporotic compression fractures. The patient's percutaneous vertebroplasty performed at the T9 level was complicated by the asymptomatic, direct embolization of the right T9 segmental artery with penetration of cement into the radicular artery beneath the pedicle. We review the literature regarding the unusual occurrence of direct arterial cement embolization during vertebral augmentation procedures, discuss possible pathomechanisms, and alert clinicians to this potentially catastrophic vascular complication.