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Cardiovascular changes after pulmonary cement embolism: an experimental study in sheep

Krebs, Jorg, Aebli, Nikolaus, Goss, Benjamin G., Wilson, K. , Williams, R., & Ferguson, Stephen J. (2007) Cardiovascular changes after pulmonary cement embolism: an experimental study in sheep. American Journal of Neuroradiology, 28(6), pp. 1046-1050.

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Abstract

BACKGROUND AND PURPOSE: Most cement leaks during vertebroplasty are asymptomatic, but pulmonary cement embolism has been reported to cause cardiovascular disturbances and even death. Adding hydroxyapatite (HA) to polymethylmethacrylate (PMMA) cement to reduce the quantity of barium may aggravate cardiovascular deterioration in the event of cement embolism by activating coagulation. Thus, we investigated the cardiovascular changes after pulmonary cement embolism of PMMA with and without HA.

MATERIALS AND METHODS: In 13 sheep, cement (2.0 mL) was injected into the pulmonary trunk. Two different cements were used: 1) standard PMMA and 2) PMMA with 10% HA (PMMA & HA). Arterial, central venous and pulmonary arterial pressures, heart rate, and cardiac output were monitored continuously until 60 minutes after the injection. Blood gases and coagulation parameters (antithrombin, D-dimer) were measured before and after injection.

RESULTS: Mean pulmonary arterial pressure had increased by approximately 9% (PMMA) and 14% (PMMA & HA) 1 minute after injection and stayed elevated. There were no significant differences between the groups. No evidence of thromboembolism was detected.

CONCLUSION: Cement embolism did not result in clinically significant pulmonary arterial hypertension. Adding HA to PMMA cement did not cause more severe cardiovascular changes.

Impact and interest:

7 citations in Scopus
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5 citations in Web of Science®

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ID Code: 14085
Item Type: Journal Article
Additional Information: For more information, please refer to the journal's website (see hypertext link) or contact the author.
DOI: 10.3174/ajnr.A0499
ISSN: 1936-959X
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2007 American Society of Neuroradiology
Deposited On: 27 Oct 2008
Last Modified: 29 Feb 2012 23:36

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