pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2019-29-3-353-359pulmo-1179Research ArticleОБЗОРЫREVIEWЭмболия легочной артерии полиметилметакрилатом (костным цементом) при проведении чрескожной вертебропластики (обзор литературы и описание клинических случаев)Pulmonary embolism with polymethyl methacrylate (bone cement) after percutaneous vertebroplasty (a review of literature and case reports)СинопальниковА. И.Sinopal’nikovA. I.

д. м. н., профессор, заведующий кафедрой пульмонологии,

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1

Doctor of Medicine, Professor, Head of Department of Pulmonology,

ul. Barrikadnaya 2/1, Moscow, 123995

aisyn@list.ruТюринИ. Е.TyurinI. E.

д. м. н., профессор, заведующий кафедрой рентгенологии и радиологии,

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1

Doctor of Medicine, Professor, Head of Department of Radiology,

ul. Barrikadnaya 2/1, Moscow, 123995

igortyurin@gmail.comШвайкоС. Н.ShvaykoS. N.

к. м. н., заведующая пульмонологическим отделением,

125284, Москва, 2-й Боткинский пр-д, 5

Candidate of Medicine, Head of Pulmonology Department,

Vtoroy Botkinskiy proyezd 5, Moscow, 125284

s.shvaiko@mail.ruШейхЖ. В.SheykhZh. V.

д. м. н., профессор кафедры рентгенологии и радиологии, 125993, Москва, ул. Баррикадная, 2 / 1, стр. 1;

заведующая отделением компьютерной томографии, врач-рентгенолог, 125284, Москва, 2-й Боткинский пр-д, 5

Doctor of Medicine, Professor, Department of Radiology, ul. Barrikadnaya 2/1, Moscow, 123995;

Head of Department of Computed Tomography, Vtoroy Botkinskiy proyezd 5, Moscow, 125284

zhanna.sheikh@mail.ruМорозоваЛ. В.MorozovaL. V.

врач-пульмонолог пульмонологического отделения,

125284, Москва, 2-й Боткинский пр-д, 5

pulmonologist, Pulmonology Department,

Vtoroy Botkinskiy proyezd 5, Moscow, 125284

mlarisa143@gmail.comСмирновИ. П.SmirnovI. P.

ассистент кафедры пульмонологии,

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1

Assistant Lecture, Department of Radiology,

ul. Barrikadnaya 2/1, Moscow, 123995

smip@ya.ruФедеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRussian Federal Academy of Continued Medical Education, Healthcare Ministry of RussiaRussian FederationГосударственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница имени С.П.Боткина» Департамента здравоохранения города МосквыРоссияS.P.Botkin Moscow City Teaching Hospital, Moscow Healthcare DepartmentRussian FederationФедеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; Государственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница имени С.П.Боткина» Департамента здравоохранения города МосквыРоссияRussian Federal Academy of Continued Medical Education, Healthcare Ministry of Russia; S.P.Botkin Moscow City Teaching Hospital, Moscow Healthcare DepartmentRussian Federation201917082019293353359Copyright © Синопальников А.И., Тюрин И.Е., Швайко С.Н., Шейх Ж.В., Морозова Л.В., Смирнов И.П., 20192019Синопальников А.И., Тюрин И.Е., Швайко С.Н., Шейх Ж.В., Морозова Л.В., Смирнов И.П.Sinopal’nikov A.I., Tyurin I.E., Shvayko S.N., Sheykh Z.V., Morozova L.V., Smirnov I.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1179

Чрескожная вертебропластика (ЧКВП) – малоинвазивное вмешательство, широко распространенное в настоящее время при лечении болевого синдрома, обусловленного переломами тел позвонков на почве остеопороза, травмы или их опухолевого поражения. Несмотря на минимальную инвазивность (ЧКВП заключается во введении полиметилметакрилата через ножку дуги в тело позвонка с целью восстановления его высоты, стабилизации костных трабекул и облегчения / купирования болевого синдрома), данный метод характеризуется немалым числом осложнений, которые в большинстве случаев не имеют серьезного клинического значения. К числу потенциально серьезных осложнений ЧКВП относится эмболия легочной артерии (ЭЛА) полиметилакрилатом (костным цементом), проявления которой отличаются разнообразием – от случайной рентгенологической находки в послеоперационном периоде до пусть редких, но жизнеугрожающих эпизодов экстравазации («утечки») цемента, заканчивающихся фатально. В представленном обзоре литературы обсуждаются вопросы эпидемиологии, патогенеза ЭЛА при ЧКВП, клинико-рентгенологические варианты данного осложнения и подходы к его лечению. В статье также приведены 2 клинических примера ЭЛА у пациентов, перенесших ЧКВП по поводу гемангиомы тел позвонков с выраженным болевым синдромом.

Percutaneous vertebroplasty (PVP) is a minimally invasive intervention widely used for relief of pain caused by osteoporotic, traumatic, or neoplastic vertebral fractures. During PVP, polymethyl methacrylate (bone cement) is injected directly into the vertebral body via a vertebral pedicle to partially restore the vertebral body height, to stabilize bone trabeculae and to alleviate pain. Though the procedure is minimally invasive, complications are not rare; however, mostly, they are not clinically significant. Potentially serious complications of PVP include pulmonary embolism with polymethyl methacrylate with variety of manifestations ranging from asymptomatic postoperative x-ray findings to life-threatening extravasation (cement "leakage") which is quite rare and fatal. Epidemiology, pathogenesis, clinical and radiological signs of pulmonary embolism in PVP and approaches to treatment are discussed in this review of literature. The article also describes two clinical cases of pulmonary embolism in patients underwent PVP for hemangioma of the vertebral body with severe pain syndrome are also described.

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The authors declare that there are no conflicts of interest present.