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Multiple cholesterol emboli syndrome after angiography.

S J Rosansky, E G Deschamps

    The American Journal of the Medical Sciences
    |July 1, 1984
    PubMed
    Summary

    Multiple cholesterol emboli syndrome (MCES) is a rare complication following angiography, particularly in patients with severe atherosclerosis. This review highlights the poor prognosis and emphasizes the need for meticulous angiographic technique to prevent MCES.

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    Area of Science:

    • Cardiovascular Medicine
    • Interventional Radiology
    • Vascular Surgery

    Background:

    • Multiple cholesterol emboli syndrome (MCES) is an infrequent but serious complication following angiographic procedures.
    • Patients with extensive atherosclerosis are at higher risk for developing MCES post-angiography.

    Observation:

    • A review of seven cases and an additional case report of MCES following angiography were analyzed.
    • Common clinical manifestations included livedo reticularis, fever, hypertension, and technical difficulties during the procedure.

    Findings:

    • Out of eight patients with MCES post-angiography, six presented with livedo reticularis below the umbilicus.
    • Technical challenges were noted in four cases, and four patients experienced fever and/or hypertension.
    • The overall survival rate was extremely low, with only one patient surviving the syndrome.

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    Implications:

    • The findings underscore the critical importance of employing careful and precise angiographic techniques to mitigate the risk of MCES.
    • Given the limited success of current therapies, preventative measures are paramount in managing patients with advanced atherosclerosis undergoing angiography.
    • This emphasizes the need for further research into risk stratification and preventative strategies for MCES.