Bone cement pulmonary and intracardiac embolism following percutaneous vertebroplasty: a case report and literature review

Abstract

Pulmonary embolism and intracardiac cement embolism caused by venous leakage of bone cement are the most serious complications following percutaneous vertebroplasty. Although the incidence of such events is low, they are insidious due to variable clinical symptoms, prone to being overlooked, and can often lead to serious consequences. We present the case of a 73-year-old female patient diagnosed with intracardiac cement embolism and pulmonary embolism following percutaneous vertebroplasty. The patient reported precordial tingling and was subsequently admitted to our hospital. After thorough discussions within the multidisciplinary Heart Team and obtaining informed consent from both the patient and her family, a decision was made to proceed with the extraction of the cardiac foreign body under cardiopulmonary bypass. The patient had an uneventful postoperative recovery and was discharged seven days after the procedure. We report a rare case of cardiopulmonary cement embolism following percutaneous vertebroplasty. The novelty of this case lies in that, from an anesthesiologist’s perspective, we comprehensively describe the imaging features and clinical course of this rare complication, propose targeted anesthetic management and perioperative treatment strategies to improve patient outcomes, and provide clinically actionable evidence for the existing literature.