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Cardiovascular effects of polymethylmethacrylate use in percutaneous vertebroplasty
Timothy J Kaufmann1, Mary E Jensen, Gabriele Ford
1Department of Radiology, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Background And Purpose:
Previous investigators have described an association between polymethylmethacrylate (PMMA) use in hip arthroplasty and cardiovascular derangement. Our purpose was to evaluate the effects of PMMA injection on patient vital signs during percutaneous vertebroplasty.
Methods:
We retrospectively reviewed patient charts at our institution to gather blood pressure, heart rate, and arterial oxygen saturation data for the following time points: before, during, 5 minutes after, and 10 minutes after PMMA injection during percutaneous vertebroplasty. These data were obtained for 142 injections (78 patients), and preinjection vital signs were compared with vital signs during and after PMMA injection. Multivariable regression modeling was used to ascertain the effects of cardiopulmonary comorbidities on vital signs.
Results:
Mean arterial blood pressure and heart rate during, 5 minutes after, and 10 minutes after PMMA injection were not significantly different from their respective preprocedure values (P =.19-.92). Values for oxygen saturation during PMMA injection and 5 minutes thereafter were not significantly different from preprocedure values (P =.80 and.89, respectively). Oxygen saturation was significantly lower at 10 minutes after injection than before injection (P =.007), although the mean difference was negligible (0.6%).
Conclusion:
We find no generalized association between PMMA injection during percutaneous vertebroplasty and systemic cardiovascular derangement.
Insights
Polymethylmethacrylate (PMMA) injection during percutaneous vertebroplasty did not cause significant cardiovascular changes. Vital signs remained stable, showing no generalized association with systemic cardiovascular derangement.
Area of Science:
- Orthopedic Surgery
- Interventional Radiology
- Cardiovascular Medicine
Background:
- Previous studies linked polymethylmethacrylate (PMMA) use in hip arthroplasty to cardiovascular issues.
- The safety of PMMA in other procedures requires further investigation.
Purpose of the Study:
- To evaluate the impact of PMMA injection on patient vital signs during percutaneous vertebroplasty.
- To determine if PMMA use in vertebroplasty is associated with cardiovascular derangement.
Main Methods:
- Retrospective review of 142 percutaneous vertebroplasty procedures (78 patients).
- Collected blood pressure, heart rate, and oxygen saturation data before, during, and after PMMA injection.
- Utilized multivariable regression to analyze the influence of comorbidities on vital signs.
Main Results:
- No significant differences in mean arterial blood pressure or heart rate were observed during or after PMMA injection compared to pre-procedure values.
- Arterial oxygen saturation showed no significant changes during or immediately after PMMA injection.
- A minor, statistically significant decrease in oxygen saturation was noted 10 minutes post-injection, but the clinical difference was negligible.
Conclusions:
- PMMA injection during percutaneous vertebroplasty is not associated with generalized systemic cardiovascular derangement.
- The study suggests a safe cardiovascular profile for PMMA use in this specific procedure.