Facial Cutaneous Cholesterol Embolism Revealing a Tight Carotid Stenosis: A Case Report

Idrissi, R. El; Ounani, F. El; Khloufi, Samir El; Martin, Samuel P.; Bensaïd, Y.; Clément, Claude

doi:10.1016/j.ejvs.2006.09.003

Cited by 3 publications

(2 citation statements)

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“…Several reports show that patients with CCE have involvement of the carotid arteries as well as the aorta. 4,5 We examined carotid plaque characteristics and confirmed that carotid complex plaques can be a surrogate marker of systemic instability of patients with CCE.The second study was a prospective investigation of the relationship between ACP and CCE. In addition, we aimed to establish criteria for predicting ACP at high risk of leading to CCE.…”

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Combined Assessment of Carotid Vulnerable Plaque, Renal Insufficiency, Eosinophilia, and hs-CRP for Predicting Risky Aortic Plaque of Cholesterol Crystal Embolism

Machino‐Ohtsuka

Seo

Ishizu

et al. 2010

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp holesterol crystal embolism (CCE) is a serious complication of vascular procedures such as angiography and cardiovascular surgery. Vulnerable aortic plaques are easily disrupted by mechanical contact during the procedure and induce embolization of cholesterol crystals. CCE causes a systemic inflammatory response that leads to multi-organ dysfunction. Effective therapy has not yet been established, and mortality from CCE is still high. 1,2 It has been reported that detection of aortic complex plaques (ACP), which are the embolic source, contributes to prevention of stroke resulting from cardiovascular surgery. 3 We hypothesized that the same theory holds for CCE after catheterization procedures and designed the present studies to confirm this. First, we investigated whether patients with CCE have ACP and second, we evaluated whether patients with ACP tend to present with CCE after catheter-based procedures.Our first study retrospectively evaluated the clinical characteristics and systemic plaque instability of patients with CCE, based on the ultrasound findings of the carotid arteries and aortic wall. Several reports show that patients with CCE have involvement of the carotid arteries as well as the aorta. 4,5 We examined carotid plaque characteristics and confirmed that carotid complex plaques can be a surrogate marker of systemic instability of patients with CCE.The second study was a prospective investigation of the relationship between ACP and CCE. In addition, we aimed to establish criteria for predicting ACP at high risk of leading to CCE. We recruited patients scheduled for catheterization procedures and performed blood tests and ultrasonographic evaluation of the carotid arteries and thoracic aorta. We explored the occurrence of CCE after the catheterization procedures and the factors associated with aortic plaque instability. Background: Cholesterol crystal embolism (CCE) is a serious complication of vascular procedures and based on the clinical features of patients with CCE, the aim of the present study was to establish screening criteria for aortic complex plaques (ACP) at high-risk of CCE.

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