Microembolic Complications of Atherosclerosis

Retan, J. Walden; Miller, Robert E.

doi:10.1001/archinte.1966.00290180010004

Cited by 57 publications

(9 citation statements)

References 41 publications

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“…More recently, Levine et al [52] reported a case of persistent eosinophilia in a pa tient with spontaneous renal atheroembolic disease. We defined eosinophilia as greater than 500 eosinophils/pl of blood [64], In our review, 80 patients had a well-docu mented full blood count performed of whom 57 patients (71%) had eosinophilia [9,12,21,23,28,36,41,44,46,52,53,56,57,65]. Eosinophilia was usually transient but may be persistent and ranged from 5 to 42%.…”

Section: Clinical Presentationmentioning

confidence: 99%

Renal Cholesterol Embolic Disease

Lye

Cheah²,

Sinniah³

1993

Am J Nephrol

111

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Renal cholesterol embolization is a rare disease occurring usually in elderly men who had undergone an angiographic procedure or vascular surgery. We report a man who developed systemic cholesterol embolic disease and acute renal failure after coronary angiography. A review of the English literature for renal cholesterol embolic disease revealed a high incidence of eosinophila (71 %). Livedo reticularis and digital infarcts occurred in more than 30% of patients. Forty percent of patients required dialysis for acute renal failure of whom only one fifth recovered sufficient renal function to stop dialysis. The overall mortality was high at 64%. Skin, muscle and kidney biopsies remain the main tools for diagnosis.

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Section: Clinical Presentationmentioning

confidence: 99%

Renal Cholesterol Embolic Disease

Lye

Cheah²,

Sinniah³

1993

Am J Nephrol

111

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“…Kommt es zur Ruptur eines solchen arteriosklerotischen Beetes, können Cholesterinkristalle abgehen und sich mit dem Blutstrom in die Gefäße unterschiedlichster Organe, wie Niere, Milz, Darm, Muskulatur oder Haut, absetzen [16,6,19], aber auch des zentralen Nervensystems [18,12,3,4,9,7]. 60-100 µm langen Cholesterinkristallen, die sich im histopathologischen Präparat als nadelförmige Gebilde darstellen.…”

Section: Hirninfarkt · Enzephalomalazien · Multiple Cholesterinemboliunclassified

“…Dagegen bestanden ausgeprägte thrombulzeröse Läsionen der Aorta ascendens. Dies kann ein Cholesterinembolisationssyndrom mit Befall verschiedener Organsysteme, sei es spontan oder iatrogen ausgelöst, zur Folge haben [16,6,18,17,12,15,3] (ausführliche Literaturübersicht bis 1988 in [5]). Laut Amarenco et al [1] Amarenco et al [2] wiesen ein von der Dicke der Plaques des Aortenbogens abhängiges Risiko, einen Hirninfarkt zu erleiden, nach.…”

Section: Diskussionunclassified

Multiple Hirninfarkte durch spontane, synchrone Cholesterinembolien

Müller¹,

Bockholt²,

Ferbert³

2002

Der Nervenarzt

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We report on a 68-year-old patient who was admitted with hemiparesis and disorientation. Computed tomography showed several old, mostly lacunar infarcts. One week after admission, the patient became comatose. A repeat computed tomography revealed several new hypodense lesions in both hemispheres compatible with acute cerebral infarctions. Autopsy confirmed the diagnosis of numerous acute encephalomalacias of the same age which were found in different territories of the anterior cerebral circulation. Histologic examination showed the extraordinary result of multiple cholesterol emboli with a maximum in the peripheral leptomeningeal vessels. The source of the emboli was severe atherosclerosis with an ulcerated and thrombotic surface of the aorta and both carotid arteries. This case is remarkable because of its severe and synchronous emboli of cholesterol in several different cerebral territories. One has to suspect a so far unknown physical or metabolic factor responsible for the shower of emboli.

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“…Renal failure due to emboli ansmg from eroded aortic ulcerations and atherosclerotic plaques has been reported under three major clinical categories: 1) after abdominal aortic surgery for ruptured aneurysm or severe aorto-iliac disease, 2) after selective renal arteriography performed by passing a catheter retrograde via the femoral artery, and 3) after spontaneous transmission of atheroemboli from remote sites (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). ,.…”

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confidence: 99%

Renal Failure From Atheroembolism After Translumbar Aortography

Pollitt

Lee

1971

J American Geriatrics Society

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The author reports a case of renal failure due to atheroembolism precipitated by translumbar aortography. When the abdominal aorta contains atheromatous plaques, there is great danger of producing showers of atheroemboli by this procedure.Renal failure due to emboli ansmg from eroded aortic ulcerations and atherosclerotic plaques has been reported under three major clinical categories: 1) after abdominal aortic surgery for ruptured aneurysm or severe aorto-iliac disease, 2) after selective renal arteriography performed by passing a catheter retrograde via the femoral artery, and 3) after spontaneous transmission of atheroemboli from remote sites (1-17). ,.This report concerns an elderly male in whom renal failure developed after translumbar aortography; atheroemboli were found in the kidneys. The case seems noteworthy as demonstrating another cause of renal failure from atheroemboli. CASE REPORTA 63-year-old white male was admitted to MacNeal Memorial Hospital because of progressive intermittent claudication, pain at rest in the lower extremities, and discoloration of the toes. Except for a cholecystectomy, he had been in good general health until he had a myocardial infarction six months before admission. There was no history of diabetes or peripheral arterial embolic phenomena. Three months before admission, he began to complain of pain in both lower extremities. The pain was aggravated by exercise but also was present at rest. The patient noticed that the tips of his toes had become dark and discolored.The physical examination revealed a normal-appearing white male in no acute distress, who looked somewhat older than his stated age of 63. The blood pressure was 150/70 mm Hg in both upper extremities and no carotid bruits were heard. The heart sounds were normal; there were no murmurs and the rhythm was regular. The lungs were clear to percussion and auscultation. The abdomen was not distended and no organomegaly or abdominal masses could be palpated. A surgical scar was noted over the right upper quadrant. Pulsation could be felt in the abdominal aorta but no bruits were audible and there was no dilatation.Tn the lower extremities all distal pulses were present and of normal character.

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Microembolic Complications of Atherosclerosis

Cited by 57 publications

References 41 publications

Renal Cholesterol Embolic Disease

Renal Cholesterol Embolic Disease

Multiple Hirninfarkte durch spontane, synchrone Cholesterinembolien

Renal Failure From Atheroembolism After Translumbar Aortography

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