Cholesterol Embolization Syndrome Developing after Coronary Angiography in a Hemodialysis Patient

Abstract

Cholesterol Embolization Syndrome (CES) is a systemic disorder due to cholesterol crystal embolization from atherosclerotic plaques of the aorta and its major branches to the small arterioles, resulting in local ischemia and organ damage. The diagnosis is mostly missed, especially in dialysis patients. There is no definite treatment available and the mortality is relatively high. We present a hemodialysis patient with cholesterol embolization syndrome who developed discoloration of the toes and necrotic ulcers after coronary angiography and whose diagnosis was confirmed with skin biopsy, and discuss the case with literature information.

Cholesterol embolization syndrome: An under‐recognized entity in cardiovascular interventions

“…Across 23 included studies, a total of 905 cases of CES have been reported, 648 of them were iatrogenic that is, after a vascular procedure. All the studies are summarized in Table . Among the retrospective studies included in this review, the incidence of CES varied from 2.9% (for endovascular stent graft for AAA repair) to 25.5% for cardiac catheterizations and 30 % for aortograms …”