Related Experiment Video

Updated: Jul 13, 2025

Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
07:12

Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta

Published on: September 8, 2023

2.4K

Atherosclerosis of the aorta before blue toe syndrome: Spontaneously ruptured aortic plaques revealed by

Satoru Takahashi1, Sei Komatsu1, Chikao Yutani1

  • 1Cardiovascular Center, Osaka Gyoumeikan Hospital, Osaka, Japan.

Journal of Cardiology Cases
|October 11, 2023
PubMed

Insights

Blue toe syndrome in a patient with cholesterol embolization syndrome was linked to ruptured aortic plaques. Angioscopy revealed numerous cholesterol crystal emboli from puff-chandelier ruptures in the abdominal aorta.

Area of Science:

  • Vascular Surgery
  • Cardiology
  • Pathology

Background:

  • Cholesterol embolization syndrome (CES) is a serious complication following endovascular procedures.
  • Blue toe syndrome, characterized by cyanosis and pain in the lower extremities, can be a manifestation of CES.

Observation:

  • A 50-year-old male presented with acute blue toe syndrome 70 days post-endovascular therapy.
  • Computed tomography angiography indicated irregular aortic wall thickness.
  • Preoperative aortic angioscopy revealed a significant number of spontaneously ruptured aortic plaques, specifically 'puff-chandelier' ruptures, primarily in the abdominal aorta.

Findings:

  • The observed ruptured aortic plaques are hypothesized to be the source of continuous cholesterol crystal embolization.
  • This continuous embolization likely led to the patient's cholesterol embolization syndrome and subsequent blue toe syndrome.

Implications:

  • Aortic angioscopy is a valuable tool for identifying the source of cholesterol emboli, particularly ruptured plaques.
  • Understanding plaque rupture mechanisms is crucial for preventing and managing CES after vascular interventions.
  • This case highlights the importance of thorough pre-procedural assessment and post-procedural monitoring for potential CES complications.

Keywords:
AngioscopyAortaCholesterol crystalPuff-chandelier rupture

More Related Videos

A Method to Study the Correlation Between Local Collagen Structure and Mechanical Properties of Atherosclerotic Plaque Fibrous Tissue13:45

A Method to Study the Correlation Between Local Collagen Structure and Mechanical Properties of Atherosclerotic Plaque Fibrous Tissue

Published on: November 11, 2022

2.1K
Three-Dimensional Imaging of Aortic Tissues in Atherosclerosis09:55

Three-Dimensional Imaging of Aortic Tissues in Atherosclerosis

Published on: October 25, 2024

951

Related Concept Videos

Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10
Atherosclerosis I: Introduction01:30

Atherosclerosis I: Introduction

Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
9
Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
12
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
9
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
11
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
22