Skip to main content

Advertisement

Log in

Arterial embolization during percutaneous vertebroplasty resulting in bilateral renal infarcts and ischemic colitis

  • Case Report
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

This case report documents an arterial embolic event that occurred during vertebroplasty for a pathological compression fracture of T12 in a 54-year-old female with known metastatic breast carcinoma. A CT angiogram performed after the procedure demonstrated cement migration into the aorta, both kidneys, and the inferior mesenteric artery and its branches, with ischemic colitis involving the descending colon and sigmoid colon. A CT scan 4 months post-procedure demonstrated resolution of the colitis. Neovascularity and cortical destruction in malignant bone lesions are thought to contribute to arterial cement leak.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Tomé-Bermejo F, Piñera AR, Duran-Álvarez C, López-San RB, Mahillo I, Alvarez L, Pérez-Higueras A. Identification of risk factors for the occurrence of cement leakage during percutaneous vertebroplasty for painful osteoporotic or malignant vertebral fracture. Spine J (Spine Clinical Case Series). 2014;39(11):E693–E700. https://doi.org/10.1097/BRS.0000000000000294.

  2. Corcos G, Dbjay J, Mastier C, Leon S, Auperin A, De Baere T, Deschamps F. Cement leakage in percutaneous vertebroplasty for spinal metastases: A retrospective evaluation of incidence and risk factors. Spine J. 2014;39(5):E332–E338. https://doi.org/10.1097/BRS.0000000000000134.

  3. Saracen A, Kotwica Z. Treatment of multiple osteoporotic vertebral compression fractures by percutaneous cement augmentation. International Orthopaedics (SICOT). 2014;38:2309–2312. https://doi.org/10.1007/s00264-014-2470-3.

  4. Hao J, Hu ZM. Percutaneous cement vertebroplasty in the treatment of symptomatic vertebral hemangiomas. Pain Physician 2012;15:43–49. https://doi.org/10.36076/ppj.2012/15/43.

  5. Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neuro-Chirurgie. 1987;33(2).

  6. Saracen A, Kotwica Z. Complications of percutaneous vertebroplasty An analysis of 1100 procedures performed in 616 patients. Medicine (United States). 2016;95(24). https://doi.org/10.1097/MD.0000000000003850.

  7. Chen W, Kao Y, Yang S, Yu S, Tu Y, Chung K. Impact of cement leakage into disks on the development of adjacent vertebral compression fractures. J Spinal Disord Tech. 2010;23(1). https://doi.org/10.1097/BSD.0b013e3181981843.

  8. Chen Y, Tan T, Chen W, Chen C, Lee T. Intradural cement leakage: A devastatingly rare complication of vertebroplasty. Spine J. 2006;31(12). https://doi.org/10.1097/01.brs.0000219495.57470.67.

  9. Amoretti N, Hovorka I, Marcy P, Grimaud A, Brunner P, Bruneton J. Aortic embolism of cement: A rare complication of lumbar percutaneous vertebroplasty. Skelet Radiol. 2007;36(7). https://doi.org/10.1007/s00256-006-0261-7.

  10. Chung S, Lee S, Kim T, Yoo K, Jo B. Renal cement embolism during percutaneous vertebroplasty. Eur Spine J. 2006;15(5). https://doi.org/10.1007/s00586-005-0037-0.

  11. Mozaffar M, Radpay M, Zirakzadeh H, Nabavizadeh P, Sobhiye M, Langroudi R. Intra-arterial injection of acrylic cement as a complication of percutaneous vertebroplasty. J Vasc Surg. 2012;56(4). https://doi.org/10.1016/j.jvs.2012.04.010.

  12. Hashem Sesavar S, Jandaghi S, Abdolhoseinpour H, Ghofraniha A, Tofighirad N, Dogmehchi E, Goodarzynejad H. A limb-saving procedure for treatment of arterial cement embolism during lumbar percutaneous vertebroplasty: a case report. J Teh Univ Heart Ctr. 2013;8(1):61–64. Available from: http://jthc.tums.ac.ir.

  13. Rose M, Pearce B, Matthews T, Patterson M, Passman M, Jordan W. Outcomes after celiac artery coverage during thoracic endovascular aortic aneurysm repair. J Vasc Surg. 2015;62(1). https://doi.org/10.1016/j.jvs.2015.02.026.

  14. Reidy D, Ahn H, Mousavi P, Finkelstein J, Whyne C. A biomechanical analysis of intravertebral pressures during vertebroplasty of cadaveric spines with and without simulated metastases. Spine J. 2003;28(14). https://doi.org/10.1097/00007632-200307150-00011.

  15. Chew C, Craig L, Edwards R, Moss J, O'Dwyer P. Safety and efficacy of percutaneous vertebroplasty in malignancy: A systematic review. Clin Radiol. 2011;66(1). https://doi.org/10.1016/j.crad.2010.09.011.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sandeep Singh Sidhu.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sidhu, S.S., Teh, J. Arterial embolization during percutaneous vertebroplasty resulting in bilateral renal infarcts and ischemic colitis. Skeletal Radiol 52, 1969–1974 (2023). https://doi.org/10.1007/s00256-022-04254-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-022-04254-8

Keywords

Navigation