McKibbin D W, Gott V L, Hutchins G M
J Thorac Cardiovasc Surg. 1976 May;71(5):741-5.
Cholesterol embolization to the abdominal viscera is common. Fatal cholesterol embolization to the central nervous system is rare. This report describes a 55-year-old woman with severe atherosclerotic disease who underwent cardiac surgery during which she suffered a fatal cerebrovascular accident. Postmortem examination revealed multiple infarcts in the brain, eye, and spleen due to emboli of cholesterol crystals and other atheromatous debris from a ruptured atherosclerotic plaque in the ascending aorta at the site of an aortotomy for cardiopulmonary bypass. In patients known to have severe atherosclerotic disease, atheromatous embolization to the central nervous system should be regarded as a potential complication of surgical manipulation and incision of the aorta for cardiopulmonary bypass. Ophthalmoscopic examination may be of diagnostic value in such cases.
胆固醇栓塞至腹部脏器很常见。致命性胆固醇栓塞至中枢神经系统则较为罕见。本报告描述了一名患有严重动脉粥样硬化疾病的55岁女性，她在接受心脏手术期间发生了致命的脑血管意外。尸检显示，由于在升主动脉处进行体外循环心脏切开术时，一个破裂的动脉粥样硬化斑块中的胆固醇晶体及其他动脉粥样硬化碎片形成栓子，导致大脑、眼睛和脾脏出现多处梗死。在已知患有严重动脉粥样硬化疾病的患者中，动脉粥样硬化栓塞至中枢神经系统应被视为体外循环手术中对主动脉进行操作和切开的潜在并发症。在这类病例中，眼底检查可能具有诊断价值。
