Эмболия легочной артерии полиметилметакрилатом (костным цементом) при проведении чрескожной вертебропластики (обзор литературы и описание клинических случаев)

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.

чрескожная вертебропластика, легочная эмболия полиметилакрилатом

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