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骨水泥主动脉栓塞:腰椎经皮椎体成形术的一种罕见并发症。

Aortic embolism of cement: a rare complication of lumbar percutaneous vertebroplasty.

作者信息

Amoretti Nicolas, Hovorka Istvan, Marcy Pierre-Yves, Grimaud Anne, Brunner Philippe, Bruneton Jean-Noel

机构信息

Department of Radiology, Hôpital l'Archet, 06200 Nice Cedex 1, France.

出版信息

Skeletal Radiol. 2007 Jul;36(7):685-7. doi: 10.1007/s00256-006-0261-7. Epub 2007 Mar 30.

Abstract

An aortic embolus of cement occurred in a 72-year-old woman after lumbar percutaneous vertebroplasty for breast cancer metastasis. A CT scan during the procedure revealed cement migration into the aorta via the lumbar artery. The cement embolus in the aorta, along with the hook-shaped cement fragment in the lumbar artery, was asymptomatic. Thereafter, a CT scan 4 months later still showed the presence of cement in the aorta and the lumbar artery at the level of the vertebroplasty. The patient is free of complaints after 4 months without anticoagulant treatment. This rare complication occurred because the collateral arterial supplies to the breast metastasis and the retrograde migration of cement during the vertebroplasty were not recognized. Proper techniques can minimize the risk of arterial embolism caused by cement during the procedure.

摘要

一名72岁女性在接受腰椎经皮椎体成形术治疗乳腺癌转移后发生了骨水泥主动脉栓子。术中CT扫描显示骨水泥经腰动脉迁移至主动脉。主动脉内的骨水泥栓子以及腰动脉内钩状骨水泥碎片均无症状。此后,4个月后的CT扫描仍显示椎体成形术水平的主动脉和腰动脉内存在骨水泥。该患者在未接受抗凝治疗的情况下4个月后无不适主诉。这种罕见的并发症发生是因为未认识到乳腺癌转移的侧支动脉供血以及椎体成形术期间骨水泥的逆行迁移。适当的技术可将术中骨水泥引起动脉栓塞的风险降至最低。

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