Sakamoto T, Inoue N, Kunitomo K, Tokura T, Matsuo A, Inoue K, Fujita H, Miyao K, Ohta B, Kitamura M, Kato G
Department of Cardiology, Kyoto Second Red Cross Hospital, Kyoto.
J Cardiol. 2001 Feb;37(2):99-102.
A 68-year-old man with chest pain was treated under a diagnosis of angina pectoris based on coronary angiography by percutaneous transluminal coronary angioplasty including stent implantation performed by the femoral approach. About 1 month after intervention, his renal function deteriorated and purpura appeared on both feet, especially at the toe tips. He was treated under a tentative diagnosis of cholesterol embolism conservatively at the out-patient clinic. However, he was admitted by ambulance due to worsening renal failure 2 months later and died from multiple organ failure 2 weeks after admission. Autopsy examination identified cholesterol embolism due to crystal emboli in several organs. Cholesterol embolism rarely occurs after angiographic or interventional procedures, but is difficult to diagnose clinically and there is no established therapy. The number of intervention and angiography procedures is increasing, so the occurrence of embolism as a complication of these procedures might also increase.
一名68岁胸痛男性，根据冠状动脉造影诊断为心绞痛，经皮股动脉途径行冠状动脉腔内血管成形术并植入支架进行治疗。介入治疗约1个月后，其肾功能恶化，双足出现紫癜，尤其是足尖部。他在门诊以胆固醇栓塞的初步诊断接受保守治疗。然而，2个月后因肾衰竭加重通过救护车入院，入院2周后死于多器官功能衰竭。尸检发现多个器官存在由晶体栓子导致的胆固醇栓塞。胆固醇栓塞在血管造影或介入操作后很少发生，但临床诊断困难且尚无既定的治疗方法。介入和血管造影操作的数量在增加，因此这些操作作为并发症的栓塞发生率可能也会增加。
