1/47. Multiple spontaneous small bowel perforations due to systemic cholesterol atheromatous embolism.A-65-year-old man was admitted for coronary and peripheral angiography to evaluate angina pectoris and peripheral vascular disease. Following angiography, he suffered from blue toes, livedo reticularis and progressive renal failure. The patient's condition continued to deteriorate, including the development of malnutrition. Four months later he suddenly developed panperitonitis, went into shock and died. The autopsy verified multiple perforations of the small bowel with disseminated cholesterol atheromatous embolism. The other organs including kidney were also invaded by atheroembolism. This was a rare case of multiple spontaneous perforations of small bowel due to systemic cholesterol atheromatous embolism.- - - - - - - - - - ranking = 1keywords = embolism (Clic here for more details about this article) |
2/47. cholesterol embolism in a patient with inflammatory abdominal aortic aneurysm.A 66-year-old man whose renal function had progressively deteriorated had an elevated blood pressure and also was found to have an inflammatory abdominal aortic aneurysm (AAA). Blood examination revealed that he had eosinophilia. livedo reticularis of the toes developed, and a skin biopsy specimen showed embolization of atheromatous plaques in the arterioles of the subcutaneous tissue. Progressive enlargement of inflammatory AAA may have dislodged the atheromatous plaques, resulting in cholesterol embolism.- - - - - - - - - - ranking = 0.71428571428571keywords = embolism (Clic here for more details about this article) |
3/47. Aortic atherosclerotic debris detected by trans-oesophageal echocardiography--a risk factor for cholesterol embolization.The clinical syndrome of cholesterol embolization is uncommon but is associated with a poor prognosis. patients with severe atheromatous disease of the aorta appear to be at particular risk from cholesterol embolization, particularly following vascular instrumentation or surgery. Trans-oesophageal echocardiography is the investigation of choice for imaging atherosclerotic disease of the aorta, and may be useful in assessing the risk of vascular procedures, and diagnostically helpful in patients with suspected cholesterol emboli syndrome. We report five cases of athero-embolism, and illustrate the role of trans-oesophageal echocardiography in making a diagnosis of cholesterol embolization.- - - - - - - - - - ranking = 0.14285714285714keywords = embolism (Clic here for more details about this article) |
4/47. cholesterol crystal embolization causing acute renal failure.Acute renal failure due to cholesterol embolization is a complication of severe generalized arteriosclerotic disease. It occurs spontaneously, or more often, as a complication of major medical or surgical procedures such as angiography and vascular surgery. The demonstration of characteristic cholesterol crystals in tissue biopsy specimens is a pathognomonic finding. However, renal cholesterol embolism may be clinically diagnosed when renal failure develops after known inciting factors or together with systemic manifestations of atheromatous embolization such as lower extremity livedo reticularis and focal digital ischemia. We report two cases of acute renal failure in which cholesterol embolization was found in skin and renal biopsies. One patient's renal function stabilized, but not to the basal level and the other patient developed end-stage renal disease.- - - - - - - - - - ranking = 0.14285714285714keywords = embolism (Clic here for more details about this article) |
5/47. Retinal cholesterol emboli during diagnostic cardiac catheterization.Retinal embolism is a highly infrequent complication of cardiac catheterization of thrombotic, lipidic, and calcific etiology. We provide the first reported clinical case of retinal embolism caused by cholesterol crystal without systemic adverse effects as a severe complication of diagnostic cardiac catheterization. Cathet. Cardiovasc. Intervent. 51:323-325, 2000.- - - - - - - - - - ranking = 0.28571428571429keywords = embolism (Clic here for more details about this article) |
6/47. Renal transplantation in a patient with end stage renal disease due to cholesterol embolism.BACKGROUND: Renal failure due to cholesterol emboli is mostly irreversible. Therefore chronic renal replacement therapy is necessary. However, to the best of our knowledge no published experience exists with renal transplantation in patients with end-stage renal disease (ESRD) due to cholesterol embolization (CE). methods: Renal transplantation was performed in a 64-year-old man who suffered from ESRD due to CE after coronary angiography. Because our patient presented with a typical profile of cardiovascular risk factors effective long-term control of these risk factors before and after transplantation was a mandatory prerequisite before considering transplantation. RESULTS: After one rejection episode serum creatinine values have been stable and no major complications have occurred during a follow-up of 18 months. No signs of recurrent cholesterol emboli into the donated kidney were seen in renal biopsies performed due to graft rejection. CONCLUSION: cholesterol embolization is an uncommon reason for ESRD and mainly occurs after invasive vascular procedures in patients with hyperlipidemia, arterial hypertension, and smoking. Because ESRD due to CE often is irreversible, chronic renal replacement therapy may be necessary. As demonstrated in our report, renal transplantation should be considered. However, in this setting effective long-term control of the underlying risk factors before and after renal transplantation has to be ensured.- - - - - - - - - - ranking = 0.57142857142857keywords = embolism (Clic here for more details about this article) |
7/47. Fatal lipid embolism following intraarterial angiography at an early stage of arteriosclerosis.Intraarterial angiography was performed on a patient with peripheral arterial occlusive disease (Fontaine IIb). No relevant risk factors were known, and a previous angiography had been undertaken without incident. After administration of contrast medium, the patient complained of acute pain in the lower abdomen and both legs, and a sudden rise in blood pressure was observed. The patient subsequently lost consciousness and died within 1.5 h. Postmortem examination showed that death was due to peripheral atheromatous microembolism of lipids, and not cholesterol as is usual in these cases. The differential diagnosis is discussed and a review of the literature is presented.- - - - - - - - - - ranking = 0.71428571428571keywords = embolism (Clic here for more details about this article) |
8/47. Potential therapeutic effect of simvastatin on progressive renal failure and nephrotic-range proteinuria caused by renal cholesterol embolism.We report our experience with a 62-year-old Japanese man with cholesterol crystal embolism after angiographic procedures performed because of intermittent claudication. In addition to progressive renal failure and nephrotic-range proteinuria, cutaneous ischemia, consisting of livedo reticularis in the lower limbs and digital necrosis at the tip of the right toe, and fundoscopic findings showing several white spots in the branches of retinal artery were also observed. Progressive renal failure and nephrotic-range proteinuria were halted just after treatment with simvastatin. Thus, simvastatin can exert a beneficial therapeutic effect on renal cholesterol embolism.- - - - - - - - - - ranking = 0.85714285714286keywords = embolism (Clic here for more details about this article) |
9/47. cholesterol embolism causing delayed healing of a foot ulcer.A cholesterol embolism presents with various systemic and local manifestations giving rise to a diagnostic dilemma. We report a case of cholesterol embolism of the leg that delayed the healing of a foot ulcer, necessitating a toe amputation. This report points to the potential of cholesterol emboli to cause a significant compromise in the vascular supply.- - - - - - - - - - ranking = 0.85714285714286keywords = embolism (Clic here for more details about this article) |
10/47. Disseminated cholesterol embolism after coronary artery bypass grafting.blue toe syndrome caused by cholesterol emboli is a relatively benign disease. However, disseminated cholesterol embolism is a life-threatening condition. We describe here the case of a 71-year-old female admitted because of anterior chest pain and intermittent claudication. Following cardiac catheterization, warfarin potassium was administered. However, the patient's toes soon darkened bilaterally, and BUN and creatinine levels increased from the normal value. skin discoloration and renal failure were improved after stopping warfarin potassium administration. The patient underwent coronary artery bypass grafting and left femoropopliteal bypass. cerebral infarction and renal failure occurred postoperatively due to disseminated cholesterol embolism. The patient died from renal failure on the 16th postoperative day without regaining consciousness following surgery. For high risk patients, interventional procedures to the ascending aorta must be avoided. When CABG cannot be avoided for coronary revascularization, off-pump bypass and use of arterial grafts are recommended.- - - - - - - - - - ranking = 0.85714285714286keywords = embolism (Clic here for more details about this article) |
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