Sarah Fadili Hassani1, Evelyne Cormier1, Eimad Shotar1,2, Mehdi Drir3, Jean-Philippe Spano2,4, Laetitia Morardet5, Jean-Philippe Collet6, Jacques Chiras1,2, Frédéric Clarençon7,8. 1. Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, 47, Bd de l'Hôpital, 75013, Paris, France. 2. Paris VI University, Pierre et Marie Curie, Paris, France. 3. Department of Anesthesiology, Pitié-Salpêtrière Hospital, Paris, France. 4. Department of Oncoly, Pitié-Salpêtrière Hospital, Paris, France. 5. Department of Rheumatology, Pitié-Salpêtrière Hospital, Paris, France. 6. Department of Cardiology, Pitié-Salpêtrière Hospital, Paris, France. 7. Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, 47, Bd de l'Hôpital, 75013, Paris, France. fredclare5@msn.com. 8. Paris VI University, Pierre et Marie Curie, Paris, France. fredclare5@msn.com.
Abstract
OBJECTIVE: To evaluate the incidence and risk factors for ICE during a PV. MATERIALS AND METHODS: Single-center retrospective analysis of 1512 consecutive patients who underwent 1854 PV procedures for osteoporotic (34 %), malignant (39.9 %) or other cause (26.1 %) of vertebral compression fractures (VCFs)/spine tumor lesions. Only thoracic or lumbar PVs were included. PVs were performed with polymethylmethacrylate (PMMA) low-viscosity bone cement under fluoroscopic guidance. Chest imaging (X-ray or CT) was performed the same day after PV in patients with high clinical suspicion of ICE. All post-procedural chest-imaging examinations were reviewed, and all ICEs were agreed upon in consensus by two radiologists. RESULTS: ICEs were detected in 72 patients (92 cement embolisms). In 86.1 % of the cases, concomitant pulmonary artery cement leakage was detected. Symptomatic ICEs were observed in six cases (8.3% of all ICEs; 0.32% of all PV procedures). No ICE led to death or permanent sequelae. Multiple levels treated during the same PV session were associated with a higher ICE rate [OR: 3.59, 95% CI: (1.98-6.51); p < 0.001]; the use of flat panel technology with a lower ICE occurrence [OR: 0.51, 95% CI: (0.32-0.83); p = 0.007]. CONCLUSION: Intracardiac cement embolism after PV has a low incidence (3.9 % in our study). Symptomatic complications related to ICE are rare (0.3%); none was responsible for clinical sequelae in our series. KEY POINTS: • The incidence of intracardiac cement embolism (ICE) during PVP is low (3.9%). • Having a high number of treated vertebrae during the same session is a significant risk factor for ICE. • Symptomatic intracardiac cement embolisms have a low incidence (8.3% of patients with ICE).
OBJECTIVE: To evaluate the incidence and risk factors for ICE during a PV. MATERIALS AND METHODS: Single-center retrospective analysis of 1512 consecutive patients who underwent 1854 PV procedures for osteoporotic (34 %), malignant (39.9 %) or other cause (26.1 %) of vertebral compression fractures (VCFs)/spine tumor lesions. Only thoracic or lumbar PVs were included. PVs were performed with polymethylmethacrylate (PMMA) low-viscosity bone cement under fluoroscopic guidance. Chest imaging (X-ray or CT) was performed the same day after PV in patients with high clinical suspicion of ICE. All post-procedural chest-imaging examinations were reviewed, and all ICEs were agreed upon in consensus by two radiologists. RESULTS: ICEs were detected in 72 patients (92 cement embolisms). In 86.1 % of the cases, concomitant pulmonary artery cement leakage was detected. Symptomatic ICEs were observed in six cases (8.3% of all ICEs; 0.32% of all PV procedures). No ICE led to death or permanent sequelae. Multiple levels treated during the same PV session were associated with a higher ICE rate [OR: 3.59, 95% CI: (1.98-6.51); p < 0.001]; the use of flat panel technology with a lower ICE occurrence [OR: 0.51, 95% CI: (0.32-0.83); p = 0.007]. CONCLUSION:Intracardiac cement embolism after PV has a low incidence (3.9 % in our study). Symptomatic complications related to ICE are rare (0.3%); none was responsible for clinical sequelae in our series. KEY POINTS: • The incidence of intracardiac cement embolism (ICE) during PVP is low (3.9%). • Having a high number of treated vertebrae during the same session is a significant risk factor for ICE. • Symptomatic intracardiac cement embolisms have a low incidence (8.3% of patients with ICE).
Authors: Rob J M Groen; Don F du Toit; Frank M Phillips; Piet V J M Hoogland; Karel Kuizenga; Maarten H Coppes; Christo J F Muller; Marie Grobbelaar; Johannes Mattyssen Journal: Spine (Phila Pa 1976) Date: 2004-07-01 Impact factor: 3.468
Authors: Angkawipa Trongtorsak; Eltaib Saad; Abdelrahman Mustafa; Ki Seok Won; Cameron Haery; Michael H Hamblin; Muhammad S Akbar Journal: J Cardiol Cases Date: 2022-05-01