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Images in Clinical Rheumatology
Asymptomatic Bilateral Central Pulmonary Embolism Following Multiple Cement Vertebroplasties
Embolismo pulmonar central bilateral asintomático por cemento tras vertebroplastia múltiple
Luis Gorospe Sarasúaa,
Corresponding author
luisgorospe@yahoo.com

Corresponding author.
, Paola Arrietab, Deisy Barrios-Barretob, Carlos de la Puente-Bujidoc
a Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain
b Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain
c Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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        "titulo" => "Embolismo pulmonar central bilateral asintom&#225;tico por cemento tras vertebroplastia m&#250;ltiple"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; CT sagittal view where one may observe the cement material in the 5 vertebral bodies &#40;short arrows&#41;&#46; Note the presence of a cement leakage from the fifth vertebra towards the right common iliac vein &#40;long arrow&#41;&#59; this leakage is probably responsible for the cement emboli in the pulmonary arteries&#46; &#40;B and C&#41; Axial &#40;B&#41; and coronal &#40;C&#41; images of CT &#40;maximum intensity projection&#41; with very high density lineal repletion defected &#40;arrows&#41; in the lumen of the main pulmonary arteries and which represent the cement material&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of an 84-year old patient with a personal history of auricular fibrillation and colorectal adenocarcinoma who underwent a vertebroplasty of 5 lumbar vertebrae due to painful osteoporotic fractures&#46; The patient recovered from this procedure with no serious complications and was discharged on the same day as the multiple vertebroplasties were performed&#46; Three months after the vertebroplasty &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#44; due to the patient&#39;s oncological history&#44; a follow-up CT scan was performed which showed multiple acrylic cement emboli in both main pulmonary arteries&#44; extending to the lobar arteries of both lungs &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B and <span class="elsevierStyleSmallCaps">C</span>&#41;&#46; Due to the absence of any symptoms and the fact that the patient took anticoagulant drugs for his auricular fibrillation a conservative treatment approach was taken for the cement emboli &#40;CE&#41;&#44; with the patient remaining stable and with no dyspnoea or chest pain&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Radiologic demonstration of CE is increasingly common due to the progressive ageing of the population&#44; for whom vertebroplasty with cement has become a relatively safe form of treatment and to the increasingly high use of CT scans&#46; Although initially the rate of CE was described as being under 5&#37; and affected almost exclusively the peripheral pulmonary arteries&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> the latest reviews have shown that this phenomenon affects 23&#37; of patients who have undergone vertebroplasty and that it may involve more central arteries<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> &#40;as in our case&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Liabilities</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of people and animals</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that for this research no experimentation has been carried out on human beings or animals&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Data confidentiality</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have adhered to the protocol of their centre of work on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of Interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Gorospe Saras&#250;a L&#44; Arrieta P&#44; Barrios-Barreto D&#44; de la Puente-Bujido C&#46; Embolismo pulmonar central bilateral asintom&#225;tico por cemento tras vertebroplastia m&#250;ltiple&#46; Reumatol Clin&#46; 2019&#59;15&#58;e53&#8211;e54&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; CT sagittal view where one may observe the cement material in the 5 vertebral bodies &#40;short arrows&#41;&#46; Note the presence of a cement leakage from the fifth vertebra towards the right common iliac vein &#40;long arrow&#41;&#59; this leakage is probably responsible for the cement emboli in the pulmonary arteries&#46; &#40;B and C&#41; Axial &#40;B&#41; and coronal &#40;C&#41; images of CT &#40;maximum intensity projection&#41; with very high density lineal repletion defected &#40;arrows&#41; in the lumen of the main pulmonary arteries and which represent the cement material&#46;</p>"
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                        "tituloSerie" => "AJR Am J Roentgenol"
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Article information
ISSN: 21735743
Original language: English
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