Prevention of pulmonary cement embolism by inferior vena cava filter following vertebroplasty-related cement intravasation

Abstract

A 77 year old woman with recent history of vertebroplasty for treatment of multiple osteoporotic lumbar vertebral body compression fractures presented for post-procedure care. A series of radiographs and cross-sectional imaging of the lumbar spine revealed an unexpected finding of cured bone cement within a small lumbar vertebral vein, the inferior vena cava and within the spokes of an inferior vena cava filter which had originally been placed two years earlier. Inferior vena cava filters have become the standard of care to prevent pulmonary embolism in the setting of deep venous thrombosis. However, cases of foreign materials becoming entrapped in filters are uncommon despite the documented frequency of intravasation of bone cement into the circulatory system following vertebroplasty procedures. This case is significant because it illustrates the rare occurrence of an inferior vena cava filter capturing intravasated bone cement and preventing its migration to the pulmonary circulation.