Drost H, Buis B, Haan D, Hillers J A
Br Heart J. 1984 Sep;52(3):339-42. doi: 10.1136/hrt.52.3.339.
Cholesterol embolism after left heart catheterisation by the femoral approach was diagnosed in seven men (mean age 59.6 years) out of a total of 4587 catheterisations. Diabetes was present in four patients, systemic hypertension in three, and signs of extensive atherosclerosis in six; five patients were taking anticoagulant drugs. Acute pain in the legs or abdomen occurred in six patients, two of whom had abdominal angina; renal failure was present in six patients, cutaneous manifestations in five, and a cholesterol embolus was seen in the retina in one. Six out of six patients had an appreciable increase in the erythrocyte sedimentation rate and five out of five had eosinophilia within a week of catheterisation. Renal failure was progressive in five patients, one of whom required haemodialysis. Three patients required amputation of the toes because of gangrene. Four patients died within four and a half months of catheterisation from causes not directly related to cholesterol embolism. At necropsy cholesterol emboli were found in all four patients. Cholesterol embolism is a rare but serious complication of left heart catheterisation.
在4587例经股动脉途径进行左心导管插入术的患者中，有7名男性（平均年龄59.6岁）被诊断为胆固醇栓塞。4例患者患有糖尿病，3例患有系统性高血压，6例有广泛动脉粥样硬化体征；5例患者正在服用抗凝药物。6例患者出现腿部或腹部急性疼痛，其中2例有腹部绞痛；6例患者出现肾衰竭，5例有皮肤表现，1例视网膜可见胆固醇栓子。6例患者中有6例在导管插入术后一周内红细胞沉降率明显升高，5例中有5例出现嗜酸性粒细胞增多。5例患者的肾衰竭呈进行性发展，其中1例需要血液透析。3例患者因坏疽需要截趾。4例患者在导管插入术后四个半月内死于与胆固醇栓塞无直接关系的原因。尸检发现所有4例患者均有胆固醇栓子。胆固醇栓塞是左心导管插入术罕见但严重的并发症。
