Ueda M, Fujimoto T, Ogawa N, Shoji S
Department of Pathology, Osaka City University Medical School, Japan.
Acta Pathol Jpn. 1989 Mar;39(3):203-6. doi: 10.1111/j.1440-1827.1989.tb01501.x.
A 67-year-old woman with a 6-year history of angina pectoris underwent percutaneous transluminal coronary angioplasty. Just after manipulation of the guiding catheter during a second attempt at angioplasty and aortography, the patient developed intestinal obstruction with peritonitis. Laparotomy was performed, and surgical specimens taken during surgery revealed necrosis and perforation of the small intestine. Microscopical examination proved that this was the result of multiple fresh cholesterol emboli in the arteries. Postoperatively, renal failure and sepsis developed, and the patient died 13 days after surgery. Autopsy revealed multiple cholesterol emboli in arteries of the intestine, spleen, pancreas, liver and kidneys. This case demonstrates that cholesterol embolism can be a serious complication of percutaneous transluminal coronary angioplasty.
一名患有6年心绞痛病史的67岁女性接受了经皮腔内冠状动脉成形术。在第二次尝试进行血管成形术和主动脉造影期间，在操作引导导管后不久，患者出现了伴有腹膜炎的肠梗阻。进行了剖腹手术，手术中获取的手术标本显示小肠坏死和穿孔。显微镜检查证实这是动脉中多个新鲜胆固醇栓子所致。术后出现肾衰竭和败血症，患者在手术后13天死亡。尸检显示在肠道、脾脏、胰腺、肝脏和肾脏的动脉中有多个胆固醇栓子。该病例表明胆固醇栓塞可能是经皮腔内冠状动脉成形术的严重并发症。
