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Bone cement embolism attached to central venous catheter

W Schummer1, O Schlonski, M Breuer

  • 1Clinic for Anaesthesiology and Intensive Care Medicine, Friedrich Schiller University Jena, Erlanger Allee 103, Jena 07747, Germany.

British Journal of Anaesthesia
|December 10, 2013
PubMed

Insights

A rare complication of spinal poly(methyl methacrylate) (PMMA) injection occurred when PMMA embolized into the venous system, forming a mass around a central venous catheter. Prompt diagnosis and surgical retrieval were successful.

Area of Science:

  • Neurosurgery
  • Cardiology
  • Radiology

Background:

  • Poly(methyl methacrylate) (PMMA) is commonly used in spinal procedures like vertebroplasty.
  • Complications, though rare, can arise from PMMA migration.
  • Central venous catheters are essential for long-term venous access.

Observation:

  • A case of inadvertent PMMA leakage into the venous system following spinal injection.
  • Formation of a significant PMMA mass encasing a triple lumen central venous catheter in the superior vena cava.
  • The patient presented with symptoms related to the embolism and catheter obstruction.

Findings:

  • Successful retrieval of the central venous catheter and the surrounding PMMA mass via cardiothoracic surgery.
  • Histopathological analysis confirmed the embolic material as PMMA.
  • The complication highlights the potential for PMMA to enter the vascular system.

Implications:

  • Emphasizes the need for meticulous surgical technique during spinal PMMA injections.
  • Highlights the importance of vigilant monitoring for rare complications post-vertebroplasty.
  • Underscores the critical role of prompt diagnosis and multidisciplinary surgical intervention in managing PMMA embolism.
Keywords:
bone cementscentral venous catheterscomplicationpulmonary embolismshockvertebroplasty

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