Atheromatous embolization

Abstract

Atheromatous embolization is a multisystem disease complicating advanced atherosclerosis. It occurs most often as a complication of angiography, an endovascular procedure or cardiovascular surgery. Atheromatous embolization can present in a subtle manner where it is often under-recognized, or with catastrophic results including myocardial infarction, strake or acute renal failure. It may mimic other disease processes and often goes underdiagnosed and undertreated. A high clinical suspicion is the key to diagnosis. Atheromatous embolization results in significant morbidity and mortality; therefore, early recognition followed by aggressive management may help to prevent end-organ damage and improve overall clinical outcomes. Management strategies should include risk factor modification, prevention of further insults by discontinuing or avoiding predisposing factors, supportive treatment and interventional or surgical approaches to remove the atheroembolic source. Atheromatous embolization is expected to increase as our population ages and the epidemics of diabetes mellitus and obesity increase.

Atheroembolic renal disease

“…Incidence of skin lesions is about 35%. 43 However, in most recent studies, [8][9][10][11][12][44][45][46] the frequency ranged from 75% to 96%. The classic skin lesions of this disease are blue toe syndrome and livedo reticularis.…”

Early Detection of Vulnerable Atherosclerotic Plaque for Risk Reduction of Acute Aortic Rupture and Thromboemboli and Atheroemboli Using Non-Obstructive Angioscopy

“…65, 66 Embolization from the abdominal aorta may cause lower extremity ischemia. 62 CT may underestimate the atheromatous plaque burden in the aorta compared with 2-D TEE. 67 Complex plaque, defined as plaque at least 4 mm thick or having a mobile component detected on TEE, has been considered more likely to cause embolic events.…”

A Case of Acute Renal Failure Caused by Cholesterol Embolization after Carotid Artery Stenting that was Improved by Peritoneal Dialysis

“…2). Of note, significant stenosis of bilateral renal arteries was not observed in the contrasted-enhanced CT. CE after CAS and CE-related ARF were diagnosed on clinical findings (3).…”