Does thrombolysis produce cholesterol embolisation?

Stellt eine Thrombolysetherapie bei akutem Myocardinfarkt ein Risiko für retinale Embolien dar?

“…Haufigstes Manifestationsorgan solcher ,,Cholesterol-Schauer" sind die GefaBe der Haut, aber auch andere Organe wie die Niere, das Cerebrum oder die Endstrombahn der Augen konnen betroffen sein [8]. [7,9]. In der Folge ergibt sich daraus ein erhohtes Risiko fur Cholesterol-Embolisationen -auch nach nicht invasiven therapeutischen Interventionen.…”

Prospective Assessment of Cholesterol Embolization in Patients With Acute Myocardial Infarction Treated With Thrombolytic vs Conservative Therapy

“…Nineteen patients have been described with cholesterol embolization temporally related to thrombolytic therapy ( Table 4). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] The proposed cause in these patients is dissolution by the lytic agent of thrombus overlying ruptured atherosclerotic plaque, thereby exposing the inner lipid pool to the systemic circulation. However, neither this mechanism nor a causal relationship between thrombolytic therapy and cholesterol embolization has been proved.…”

Thrombolytic‐Associated Cholesterol Emboli Syndrome: Case Report and Literature Review

“…Clinical manifestations of CES in our patient were primarily of two types: peripheral cutaneous involvement and acute renal insufficiency. Localized mottling of the lower legs (livedo reticularis) is most commonly observed.7, 15,19,20,[25][26][27][28][29][30][31][32][33][34] Cholesterol crystal emboli and other atheromatous material lead to occlusion of arterioles perfusing the skin. Continued ischemia can lead to cyanosis and potentially result in dermal ulcerations and gangrene, as occurred in our patient.…”

“…The acute deterioration in renal function experienced by our patient is also typical. 7,8,15,20,27,28,[32][33][34][35][36] Renal impairment can be both acute and progressive. The gradual worsening may be due to repeated showers of emboli or to the vascular lesion induced by the emboli.'?…”