Skip to main content
NCBI home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1997 Oct;90(10):543–546. doi: 10.1177/014107689709001005

Cholesterol emboli syndrome--uncommon or unrecognized?

S P Bell 1, A Frankel 1, E A Brown 1
PMCID: PMC1296595  PMID: 9488011

Abstract

Cholesterol emboli syndrome is a multisystem disorder that can be precipitated by angiographic procedures. We report 5 cases in which the presentation was renal failure. All patients had undergone angiography, but the temporal relation of the procedure to the clinical presentation was highly variable, the interval ranging from one day to four months. With the increase in diagnostic and therapeutic uses of angiography, the cholesterol emboli syndrome is likely to become more frequent and needs to be recognized.

Full text

PDF
543

Images in this article

545Figure 1
on p.545

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bendixen B. H., Younger D. S., Hair L. S., Gutierrez C., Meyers M. L., Homma S., Jaffe I. A. Cholesterol emboli neuropathy. Neurology. 1992 Feb;42(2):428–430. doi: 10.1212/wnl.42.2.428. [DOI] [PubMed] [Google Scholar]
  2. Cabili S., Hochman I., Goor Y. Reversal of gangrenous lesions in the blue toe syndrome with lovastatin--a case report. Angiology. 1993 Oct;44(10):821–825. doi: 10.1177/000331979304401010. [DOI] [PubMed] [Google Scholar]
  3. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 38-1993. Renal failure and a painful toe in a 70-year-old man after an acute myocardial infarct. N Engl J Med. 1993 Sep 23;329(13):948–955. doi: 10.1056/NEJM199309233291309. [DOI] [PubMed] [Google Scholar]
  4. Cross S. S. How common is cholesterol embolism? J Clin Pathol. 1991 Oct;44(10):859–861. doi: 10.1136/jcp.44.10.859. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dahlberg P. J., Frecentese D. F., Cogbill T. H. Cholesterol embolism: experience with 22 histologically proven cases. Surgery. 1989 Jun;105(6):737–746. [PubMed] [Google Scholar]
  6. Drost H., Buis B., Haan D., Hillers J. A. Cholesterol embolism as a complication of left heart catheterisation. Report of seven cases. Br Heart J. 1984 Sep;52(3):339–342. doi: 10.1136/hrt.52.3.339. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fine M. J., Kapoor W., Falanga V. Cholesterol crystal embolization: a review of 221 cases in the English literature. Angiology. 1987 Oct;38(10):769–784. doi: 10.1177/000331978703801007. [DOI] [PubMed] [Google Scholar]
  8. Freund N. S. Cholesterol emboli syndrome following cardiac catheterization. Postgrad Med. 1990 Apr;87(5):55–60. doi: 10.1080/00325481.1990.11704626. [DOI] [PubMed] [Google Scholar]
  9. Frock J., Bierman M., Hammeke M., Reyes A. Atheroembolic renal disease: experience with 22 patients. Nebr Med J. 1994 Sep;79(9):317–321. [PubMed] [Google Scholar]
  10. Gupta B. K., Spinowitz B. S., Charytan C., Wahl S. J. Cholesterol crystal embolization-associated renal failure after therapy with recombinant tissue-type plasminogen activator. Am J Kidney Dis. 1993 Jun;21(6):659–662. doi: 10.1016/s0272-6386(12)80040-0. [DOI] [PubMed] [Google Scholar]
  11. Kawakami Y., Hirose K., Watanabe Y., Tomioka N., Doyama K., Morikawa M., Kosuga K., Saiga T. Management of multiple cholesterol embolization syndrome--a case report. Angiology. 1990 Mar;41(3):248–252. doi: 10.1177/000331979004100311. [DOI] [PubMed] [Google Scholar]
  12. Lye W. C., Cheah J. S., Sinniah R. Renal cholesterol embolic disease. Case report and review of the literature. Am J Nephrol. 1993;13(6):489–493. doi: 10.1159/000168669. [DOI] [PubMed] [Google Scholar]
  13. Mannesse C. K., Blankestijn P. J., Man in 't Veld A. J., Schalekamp M. A. Renal failure and cholesterol crystal embolization: a report of 4 surviving cases and a review of the literature. Clin Nephrol. 1991 Nov;36(5):240–245. [PubMed] [Google Scholar]
  14. Nasser T. K., Mohler E. R., 3rd, Wilensky R. L., Hathaway D. R. Peripheral vascular complications following coronary interventional procedures. Clin Cardiol. 1995 Nov;18(11):609–614. doi: 10.1002/clc.4960181105. [DOI] [PubMed] [Google Scholar]
  15. Palmer F. J., Warren B. A. Multiple cholesterol emboli syndrome complicating angiographic techniques. Clin Radiol. 1988 Sep;39(5):519–522. doi: 10.1016/s0009-9260(88)80221-6. [DOI] [PubMed] [Google Scholar]
  16. Palmer F. J., Warren B. A. Multiple cholesterol emboli syndrome complicating angiographic techniques. Clin Radiol. 1988 Sep;39(5):519–522. doi: 10.1016/s0009-9260(88)80221-6. [DOI] [PubMed] [Google Scholar]
  17. Peat D. S., Mathieson P. W. Cholesterol emboli may mimic systemic vasculitis. BMJ. 1996 Aug 31;313(7056):546–547. doi: 10.1136/bmj.313.7056.546. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Preston R. A., Stemmer C. L., Materson B. J., Perez-Stable E., Pardo V. Renal biopsy in patients 65 years of age or older. An analysis of the results of 334 biopsies. J Am Geriatr Soc. 1990 Jun;38(6):669–674. doi: 10.1111/j.1532-5415.1990.tb01427.x. [DOI] [PubMed] [Google Scholar]
  19. Ramirez G., O'Neill W. M., Jr, Lambert R., Bloomer H. A. Cholesterol embolization: a complication of angiography. Arch Intern Med. 1978 Sep;138(9):1430–1432. [PubMed] [Google Scholar]
  20. Rosansky S. J., Deschamps E. G. Multiple cholesterol emboli syndrome after angiography. Am J Med Sci. 1984 Jul-Aug;288(1):45–48. doi: 10.1097/00000441-198407000-00012. [DOI] [PubMed] [Google Scholar]
  21. Sheehan M. G., Condemi J. J., Rosenfeld S. I. Position dependent livedo reticularis in cholesterol emboli syndrome. J Rheumatol. 1993 Nov;20(11):1973–1974. [PubMed] [Google Scholar]
  22. Smith M. C., Ghose M. K., Henry A. R. The clinical spectrum of renal cholesterol embolization. Am J Med. 1981 Jul;71(1):174–180. doi: 10.1016/0002-9343(81)90290-4. [DOI] [PubMed] [Google Scholar]
  23. THURLBECK W. M., CASTLEMAN B. Atheromatous emboli to the kidneys after aortic surgery. N Engl J Med. 1957 Sep 5;257(10):442–447. doi: 10.1056/NEJM195709052571002. [DOI] [PubMed] [Google Scholar]
  24. Tilley W. S., Harston W. E., Siami G., Stone W. J. Renal failure due to cholesterol emboli following PTCA. Am Heart J. 1985 Dec;110(6):1301–1302. doi: 10.1016/0002-8703(85)90031-6. [DOI] [PubMed] [Google Scholar]
  25. Zaytsev P., Miller K., Pellettiere E. V. Cutaneous cholesterol emboli with infarction clinically mimicking heparin necrosis--a case report. Angiology. 1986 Jun;37(6):471–476. doi: 10.1177/000331978603700608. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES