Cholesterol Embolism Questions & Answers

1. Ozkok A. Cholesterol-embolization syndrome: current perspectives. Vasc Health Risk Manag. 2019. 15:209-220. [QxMD MEDLINE Link].

2. Li X, Bayliss G, Zhuang S. Cholesterol Crystal Embolism and Chronic Kidney Disease. Int J Mol Sci. 2017 May 24. 18 (6):[QxMD MEDLINE Link]. [Full Text].

3. Takahashi K, Omuro A, Ohya M, Kubo S, Tada T, Tanaka H, et al. Incidence, Risk Factors, and Prognosis of Cholesterol Crystal Embolism Because of Percutaneous Coronary Intervention. Am J Cardiol. 2022 Mar 15. 167:15-19. [QxMD MEDLINE Link]. [Full Text].

4. Ghimire B , Khanal K , Bajracharya A , Koirala M. Ischemic Stroke as a Manifestation of Cholesterol Embolization Syndrome Following Percutaneous Coronary Intervention. Kathmandu Univ Med J (KUMJ). 2021 Jan.-Mar. 19 (73):143-145. [QxMD MEDLINE Link].

5. Oe K, Araki T, Nakashima A, Sato K, Konno T, Yamagishi M. Late onset of cholesterol crystal embolism after thrombolysis for cerebral infarction. Intern Med. 2010. 49 (9):833-6. [QxMD MEDLINE Link]. [Full Text].

6. Higo S, Hirama A, Ueda K, Mii A, Kaneko T, Utsumi K, et al. A patient with idiopathic cholesterol crystal embolization: effectiveness of early detection and treatment. J Nippon Med Sch. 2011. 78 (4):252-6. [QxMD MEDLINE Link].

7. Jucgla A, Moreso F, Muniesa C, Moreno A, Vidaller A. Cholesterol embolism: still an unrecognized entity with a high mortality rate. J Am Acad Dermatol. 2006 Nov. 55 (5):786-93. [QxMD MEDLINE Link].

8. Willens HJ, Kramer HJ, Kessler KM. Transesophageal echocardiographic findings in blue toe syndrome exacerbated by anticoagulation. J Am Soc Echocardiogr. 1996 Nov-Dec. 9 (6):882-4. [QxMD MEDLINE Link].

9. Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A, Takeshita A, Cholesterol Embolism Study(CHEST) Investigators. The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study. J Am Coll Cardiol. 2003 Jul 16. 42 (2):211-6. [QxMD MEDLINE Link].

10. Acartürk E, Ozeren A, Sarica Y. Detection of aortic plaques by transesophageal echocardiography in patients with ischemic stroke. Acta Neurol Scand. 1995 Aug. 92 (2):170-2. [QxMD MEDLINE Link].

11. Adler Y, Shohat-Zabarski R, Vaturi M, Shapira Y, Ehrlich S, Jortner R, et al. Association between mitral annular calcium and aortic atheroma as detected by transesophageal echocardiographic study. Am J Cardiol. 1998 Mar 15. 81 (6):784-6. [QxMD MEDLINE Link].

12. Katz ES, Tunick PA, Rusinek H, Ribakove G, Spencer FC, Kronzon I. Protruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypass: experience with intraoperative transesophageal echocardiography. J Am Coll Cardiol. 1992 Jul. 20 (1):70-7. [QxMD MEDLINE Link].

13. Ribakove GH, Katz ES, Galloway AC, Grossi EA, Esposito RA, Baumann FG, et al. Surgical implications of transesophageal echocardiography to grade the atheromatous aortic arch. Ann Thorac Surg. 1992 May. 53 (5):758-61; discussion 762-3. [QxMD MEDLINE Link].

14. Tenenbaum A, Garniek A, Shemesh J, Fisman EZ, Stroh CI, Itzchak Y, et al. Dual-helical CT for detecting aortic atheromas as a source of stroke: comparison with transesophageal echocardiography. Radiology. 1998 Jul. 208 (1):153-8. [QxMD MEDLINE Link].

15. Kondo Y, Kanzaki M, Ishima D, Usui R, Kimura A, Usui K, et al. Cholesterol crystal embolism-related cerebral infarction: Magnetic resonance imaging and clinical characteristics. eNeurologicalSci. 2021 Dec. 25:100388. [QxMD MEDLINE Link]. [Full Text].

16. Manganoni AM, Venturini M, Scolari F, Tucci G, Facchetti F, Graifemberghi S, et al. The importance of skin biopsy in the diverse clinical manifestations of cholesterol embolism. Br J Dermatol. 2004 Jun. 150 (6):1230-1. [QxMD MEDLINE Link].

17. Belenfant X, Meyrier A, Jacquot C. Supportive treatment improves survival in multivisceral cholesterol crystal embolism. Am J Kidney Dis. 1999 May. 33 (5):840-50. [QxMD MEDLINE Link].

18. Masuda J, Tanigawa T, Nakamori S, Sawai T, Murata T, Ishikawa E, et al. Use of corticosteroids in the treatment of cholesterol crystal embolism after cardiac catheterization: a report of four Japanese cases. Intern Med. 2013. 52 (9):993-8. [QxMD MEDLINE Link].

19. Elinav E, Chajek-Shaul T, Stern M. Improvement in cholesterol emboli syndrome after iloprost therapy. BMJ. 2002 Feb 2. 324 (7332):268-9. [QxMD MEDLINE Link]. [Full Text].

20. Hasegawa M, Sugiyama S. Apheresis in the treatment of cholesterol embolic disease. Ther Apher Dial. 2003 Aug. 7 (4):435-8. [QxMD MEDLINE Link].

21. Verneuil L, Ze Bekolo R, Dompmartin A, Comoz F, Marcelli C, Leroy D. Efficiency of colchicine and corticosteroids in a leg ulceration with cholesterol embolism in a woman with rheumatoid arthritis. Rheumatology (Oxford). 2003 Aug. 42 (8):1014-6. [QxMD MEDLINE Link].

22. Sevillano-Prieto ÁM, Hernández-Martínez E, Caro-Espada J, Molina-Gómez M, Gutiérrez-Martínez E, Morales-Ruiz E, et al. Cholesterol atheroembolism and combined treatment with steroids and iloprost. Nefrologia. 2012. 32 (6):824-8. [QxMD MEDLINE Link].

23. Sanai T, Matsui R, Hirano T. LDL apheresis for cholesterol embolism following coronary artery bypass graft surgery--a case report. Angiology. 2006 May-Jun. 57 (3):379-82. [QxMD MEDLINE Link].

24. Ishiyama K, Sato T, Taguma Y. Low-Density Lipoprotein Apheresis Ameliorates Renal Prognosis of Cholesterol Crystal Embolism. Ther Apher Dial. 2015 Aug. 19 (4):355-60. [QxMD MEDLINE Link].

25. Ishiyama K, Sato T, Yamaguchi T, Taguma Y. Efficacy of low-density lipoprotein apheresis combined with corticosteroids for cholesterol crystal embolism. Clin Exp Nephrol. 2017 Apr. 21 (2):228-235. [QxMD MEDLINE Link].

26. Lowe HC, Houser SL, Aretz T, MacNeill BD, Oesterle SN, Palacios IF. Significant atheromatous debris following uncomplicated vein graft direct stenting: evidence supporting routine use of distal protection devices. J Invasive Cardiol. 2002 Oct. 14 (10):636-9. [QxMD MEDLINE Link].

27. Carroccio A, Olin JW, Ellozy SH, Lookstein RA, Valenzuela R, Minor ME, et al. The role of aortic stent grafting in the treatment of atheromatous embolization syndrome: results after a mean of 15 months follow-up. J Vasc Surg. 2004 Sep. 40 (3):424-9. [QxMD MEDLINE Link].

Lisa Kirkland, MD, FACP, FCCM, MSHA Assistant Professor, Department of Internal Medicine, Division of Hospital Medicine, Mayo Clinic; Chair, Department of Critical Care, ANW Intensivists, Abbott Northwestern Hospital

Lisa Kirkland, MD, FACP, FCCM, MSHA is a member of the following medical societies: American College of Physicians, Society of Critical Care Medicine, Society of Hospital Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Vincent Lopez Rowe, MD, FACS Professor and Chief, Division of Vascular and Endovascular Surgery, Gonda (Goldschmied) Vascular Center, University of California, Los Angeles, David Geffen School of Medicine

Vincent Lopez Rowe, MD, FACS is a member of the following medical societies: American College of Surgeons, American Heart Association, American Surgical Association, Pacific Coast Surgical Association, Society for Clinical Vascular Surgery, Society for Vascular Surgery, Society of Black Academic Surgeons, Society of Black Vascular Surgeons, Southern California Vascular Surgical Society, Western Vascular Society

Disclosure: Nothing to disclose.

• Print this section
• Print the entire contents of
• Print the entire contents of article