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Massive cement pulmonary embolism during percutaneous vertebroplasty
  1. María Elena Arnáiz-García,
  2. María José Dalmau-Sorlí,
  3. Jose María González-Santos
  1. Cardiac Surgery Department, University Hospital of Salamanca, Salamanca, Spain
  1. Correspondence to Dr María Elena Arnáiz-García, Cardiac Surgery Department, University Hospital of Salamanca, Paseo de San Vicente 58-182, Salamanca 37007, Spain; elearnaiz{at}hotmail.com

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A 71-year-old woman was admitted to hospital after a car crash and diagnosed with L1 vertebral body fracture. A percutaneous transpedicular lumbar fixation using polymethylmethacrylate (PMMA) cement was decided. During the procedure, a massive PMMA cement leakage into the paravertebral venous system was observed. Hypotension, acute respiratory distress and refractory hypoxaemia were rapidly manifested. A cement pulmonary embolism was suspected and an unenhanced CT performed. A large collection of PMMA fragments were distinguished in the right pulmonary artery (RPA) and lobar branches (figure …

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