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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
Summary
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.
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