ABSTRACT
A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.
Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma/secondary , Bone Cements/adverse effects , Embolism/etiology , Iliac Vein , Lumbar Vertebrae/surgery , Lung Neoplasms/pathology , Pulmonary Embolism/prevention & control , Spinal Neoplasms/secondary , Vena Cava Filters , Vena Cava, Inferior , Venous Thrombosis/diagnostic imaging , Vertebroplasty/adverse effectsABSTRACT
Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma. To our knowledge, only 11 cases have been previously reported. We recently encountered two cases of CLE in our clinical work. Reviewing the 11 cases in the literature and the two cases in our report indicates that large dose lipiodol infusion and absence of particulate embolization should be avoided. The presence of a right-to-left shunt and inferior phrenic artery injection seems to increase the risk of CLE. More caution should be taken in these situations.