Pulmonary cement embolism

peptide and troponin I were normal (65.5 pg/mL and < 0.01 ng/mL, respectively). Doppler ultrasound of the lower extremities showed no deep vein thrombosis, and echocardiography showed left ventricular diastolic dysfunction (grade 1) with no right-sided abnormalities. Chest CT showed embolized polymethylmethacrylate cement in the azygos system and pulmonary arteries (Figures 1 and 2, respectively). Anticoagulation therapy was started. Although pulmonary cement embolism (PCE) is a known complication of vertebroplasty, its exact incidence remains controversial, reportedly ranging from 2.1%, in a retrospective study,(1) to 24.0%, in a prospective study.(2) In the former study,(1) all PCE patients remained asymptomatic for the first year of follow-up; in the latter,(2) most of the emboli were small and peripheral. However, symptoms can develop, and fatal events have been reported.(2) In a systematic review, Krueger et al.(3) identified no best management strategy but concluded that PCE patients with symptomatic peripheral Pulmonary cement embolism