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Management of multiple cholesterol embolization syndrome--a case report
Y Kawakami1, K Hirose, Y Watanabe
1Department of Cardiology, Otsu Red Cross Hospital, Shiga, Japan.
Angiology
|March 1, 1990
Summary
Multiple cholesterol embolization syndrome (MCES) is a rare complication of cardiac procedures. A novel treatment approach involving hemostatic and antihyperlipidemic drugs showed temporary improvement in a patient with MCES.
Area of Science:
- Cardiology
- Nephrology
- Dermatology
Background:
- Coronary angiography and acute myocardial infarction treatments can precipitate serious complications.
- Multisystemic injury, including renal and cutaneous manifestations, can arise post-procedure.
Observation:
- A 62-year-old man developed multisystemic injury after coronary angiography and thrombolytic therapy.
- Diagnosis of multiple cholesterol embolization syndrome (MCES) was confirmed via fundoscopic examination and skin biopsy.
- Severe aortic atherosclerosis was noted, with cholesterol emboli found in multiple organs postmortem.
Findings:
- Discontinuation of anticoagulants and administration of hemostatic and antihyperlipidemic agents led to temporary improvement in cutaneous and renal symptoms.
- The patient experienced extended survival of approximately one year following the intervention.
- Postmortem examination confirmed widespread cholesterol emboli, indicating MCES as the cause of multisystemic injury.
Implications:
- Multiple cholesterol embolization syndrome (MCES) is a rare but significant complication of left heart catheterization and anticoagulant therapy.
- The optimal treatment strategy for MCES is not yet established.
- The described therapeutic regimen, combining hemostatic and antihyperlipidemic drugs, may offer a potential management approach for MCES.