Percutaneous Retrieval of an Embolized Kyphoplasty Cement Fragment From the Pulmonary Artery: A Case Report and Literature Review

Abstract

We present a case of a 41-year-old man with symptomatic pulmonary cement embolism following percutaneous vertebral augmentation, which was successfully retrieved via a percutaneous endovascular approach, a novel technique with only two prior cases reported.  Cement leakage, including venous embolization of cement into the cardiopulmonary circulation, is a known potential complication following percutaneous kyphoplasty and vertebroplasty. While many patients with pulmonary cement embolism are asymptomatic and likely go undiagnosed, others experience respiratory distress and hemodynamic compromise requiring surgical and medical intervention.  The optimal management for pulmonary cement embolism must be tailored to fit each individual patient, dependent upon the acuity of the clinical presentation, coexisting patient comorbidities, and the risks of systemic anticoagulation.  In our patient, cement migration was visualized in real-time during vertebral augmentation.  Endovascular retrieval by our Interventional Radiology section obviated the need for anticoagulation therapy or more invasive open surgical procedures.