Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty.

Autor: D'Errico S; Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy. Electronic address: stefano.derrico@uslnordovest.toscana.it., Niballi S; Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy., Bonuccelli D; Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy.
Jazyk: angličtina
Zdroj: Journal of forensic and legal medicine [J Forensic Leg Med] 2019 Apr; Vol. 63, pp. 48-51. Date of Electronic Publication: 2019 Mar 05.
DOI: 10.1016/j.jflm.2019.03.004
Abstrakt: Percutaneous vertebroplasty consists of percutaneous injection of polymethylmethacrylate (PMMA) via a transpedicular approach for the treatment of collapsed osteoporotic or metastatic vertebrae. Even if percutaneous vertebroplasty is considered to be minimally invasive, threatening complications can occur. Cement leakage is the most common complication of percutaneous vertebroplasty. Rigorous patient selection and individual therapeutic strategy may reduce the occurrence of leakage, in particular the risk of cement entry into the venous system and the spinal canal is the potent major hazard of this technique. Cement pulmonary and cardiac embolism are reported in literature as a cause of unexpected death after percutaneous vertebroplasty. Authors report a fatal case of pulmonary cement embolization occurred after vertebroplasty with haemopericardium, due to the perforation of the right atrium wall from a cement solidified fragment. A complete post mortem examination documented the presence of multiple cement fragments in the pulmonary arteries and transmural perforation of the wall of the right atrium by a whitish needle-like foreign body. Pulmonary microembolization was observed under polarized light.
(Copyright © 2019 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)
Databáze: MEDLINE
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