Ischemic Stroke as a Manifestation of Cholesterol Embolization Syndrome Following Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Neurology
• Nephrology

Background:

• Cholesterol embolization syndrome (CES) is a significant cause of morbidity and mortality post-invasive coronary interventions.
• Risk factors include advanced age, male sex, atherosclerosis, anticoagulation, and femoral access.
• CES is a multisystem disease affecting various organs, including skin, kidneys, brain, eyes, and gastrointestinal tract.

Observation:

• A case report of an elderly male patient admitted to the ICU post-percutaneous coronary intervention (PCI).
• The patient presented with neurological deficits, skin changes, and renal failure.
• Cerebral MRI confirmed multiple lacunar infarcts, indicative of ischemic stroke.

Findings:

• Cholesterol embolization syndrome was suspected due to risk factors, recent PCI, and clinical presentation.
• The patient received treatment with intermittent hemodialysis, statins, and anti-platelet agents.
• Follow-up showed improvement in skin lesions and renal function, though neurological deficits persisted.

Implications:

• This case underscores the importance of considering CES in patients with multisystem involvement after PCI, especially with neurological symptoms.
• Early diagnosis and management of CES are crucial for improving patient outcomes.
• Further research is needed to understand and mitigate the long-term neurological sequelae of CES.