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J R Soc Med. 1997 October; 90(10): 543–546.
PMCID: PMC1296595

Cholesterol emboli syndrome--uncommon or unrecognized?


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.

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Selected References

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  • Palmer FJ, Warren BA. Multiple cholesterol emboli syndrome complicating angiographic techniques. Clin Radiol. 1988 Sep;39(5):519–522. [PubMed]
  • Freund NS. Cholesterol emboli syndrome following cardiac catheterization. Postgrad Med. 1990 Apr;87(5):55–60. [PubMed]
  • Zaytsev P, Miller K, Pellettiere EV. Cutaneous cholesterol emboli with infarction clinically mimicking heparin necrosis--a case report. Angiology. 1986 Jun;37(6):471–476. [PubMed]
  • Tilley WS, Harston WE, Siami G, Stone WJ. Renal failure due to cholesterol emboli following PTCA. Am Heart J. 1985 Dec;110(6):1301–1302. [PubMed]
  • Drost H, Buis B, Haan D, Hillers JA. Cholesterol embolism as a complication of left heart catheterisation. Report of seven cases. Br Heart J. 1984 Sep;52(3):339–342. [PMC free article] [PubMed]
  • Gupta BK, Spinowitz BS, Charytan C, Wahl SJ. Cholesterol crystal embolization-associated renal failure after therapy with recombinant tissue-type plasminogen activator. Am J Kidney Dis. 1993 Jun;21(6):659–662. [PubMed]
  • 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. [PubMed]
  • Nasser TK, Mohler ER, 3rd, Wilensky RL, Hathaway DR. Peripheral vascular complications following coronary interventional procedures. Clin Cardiol. 1995 Nov;18(11):609–614. [PubMed]
  • THURLBECK WM, CASTLEMAN B. Atheromatous emboli to the kidneys after aortic surgery. N Engl J Med. 1957 Sep 5;257(10):442–447. [PubMed]
  • Ramirez G, O'Neill WM, Jr, Lambert R, Bloomer HA. Cholesterol embolization: a complication of angiography. Arch Intern Med. 1978 Sep;138(9):1430–1432. [PubMed]
  • Cross SS. How common is cholesterol embolism? J Clin Pathol. 1991 Oct;44(10):859–861. [PMC free article] [PubMed]
  • Preston RA, Stemmer CL, Materson BJ, 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. [PubMed]
  • 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]
  • Rosansky SJ, Deschamps EG. Multiple cholesterol emboli syndrome after angiography. Am J Med Sci. 1984 Jul-Aug;288(1):45–48. [PubMed]
  • Peat DS, Mathieson PW. Cholesterol emboli may mimic systemic vasculitis. BMJ. 1996 Aug 31;313(7056):546–547. [PMC free article] [PubMed]
  • Dahlberg PJ, Frecentese DF, Cogbill TH. Cholesterol embolism: experience with 22 histologically proven cases. Surgery. 1989 Jun;105(6):737–746. [PubMed]
  • Bendixen BH, Younger DS, Hair LS, Gutierrez C, Meyers ML, Homma S, Jaffe IA. Cholesterol emboli neuropathy. Neurology. 1992 Feb;42(2):428–430. [PubMed]
  • Mannesse CK, Blankestijn PJ, Man in 't Veld AJ, Schalekamp MA. 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]
  • Fine MJ, Kapoor W, Falanga V. Cholesterol crystal embolization: a review of 221 cases in the English literature. Angiology. 1987 Oct;38(10):769–784. [PubMed]
  • Lye WC, Cheah JS, Sinniah R. Renal cholesterol embolic disease. Case report and review of the literature. Am J Nephrol. 1993;13(6):489–493. [PubMed]
  • Sheehan MG, Condemi JJ, Rosenfeld SI. Position dependent livedo reticularis in cholesterol emboli syndrome. J Rheumatol. 1993 Nov;20(11):1973–1974. [PubMed]
  • Smith MC, Ghose MK, Henry AR. The clinical spectrum of renal cholesterol embolization. Am J Med. 1981 Jul;71(1):174–180. [PubMed]
  • 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. [PubMed]
  • 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. [PubMed]
  • Palmer FJ, Warren BA. Multiple cholesterol emboli syndrome complicating angiographic techniques. Clin Radiol. 1988 Sep;39(5):519–522. [PubMed]

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