Emboli of cholesterol crystals

Schornagel, H. E.

doi:10.1002/path.1700810114

Cited by 22 publications

(8 citation statements)

References 8 publications

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“…The atheroemboli usually arise from the proximal aorta or proximal segments of the coronary arteries and can result in ECG changes, angina or even sudden death. 122 A few case reports have documented intramural coronary arteritis induced by cholesterol emboli [123][124][125][126] and intraoperative coronary atheroembolism has been reported in patients undergoing CABG. In these cases, the source of cholesterol emboli is usually the aortic root, native coronary arteries or an old vein bypass graft.…”

Section: Gastrointestinal Involvementmentioning

confidence: 99%

Atheromatous embolization

Liew

Bartholomew

2005

Vasc Med

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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.

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Section: Gastrointestinal Involvementmentioning

confidence: 99%

Atheromatous embolization

Liew

Bartholomew

2005

Vasc Med

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“…A major cause of vascular disease of the kidney in the elderly is atheroembolism, 68 which occurs when cholesterol crystals and other forms of atheromatous debris are dislodged from the renal artery or aorta 68 . The resultant showers of microemboli occlude the arcuate and intralobular arteries of the kidney 69–72 . Reported incidences of cholesterol atheroembolism range from 4 per cent to as high as 15–30 per cent 68,73 in patients who have severe ulcerative disease and 77 per cent in patients undergoing aneurysmectomy 70,74,75 .…”

Section: Specific Renal Diseases In the Elderlymentioning

confidence: 99%

“…Emboli of hyalinic materials with varying degrees of cellularity and lipid‐filled histiocytes have also been described 70 . The acute obstruction organizes later, with the appearance of foreign‐body giant cells and concentric fibrosis 69,71,77,78 . The multiplicity of the lesions leads to ischemic degeneration of the nephrons, with resultant pitting of the renal surface 77,79,80 and eventually, generalized atrophy of the kidney 68,71,81 .…”

Section: Specific Renal Diseases In the Elderlymentioning

confidence: 99%

“…The finding of fever, hematuria, an abnormally high ESR, leukocytosis with eosinophilia, and evidence of myocardial ischemia (all commonly associated with acute atheroembolism) may produce a clinical picture indistinguishable from that of vasculitis 82,87,88,92 . The additional clinical findings of vascular bruits, local digital ischemia, and cholesterol retinal embolism 88,94 associated with hypertension of recent onset and a known precipitating cause point to atheroembolism, but a firm diagnosis can be made only by biopsy 71,79 and is often made only at autopsy 69,80,88 . An aggressive use of biopsy of muscle, skin, kidney, or bone marrow may be needed for definitive diagnosis 82,89,95 …”

Section: Specific Renal Diseases In the Elderlymentioning

confidence: 99%

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Renal Disease in the Geriatric Patient

Frocht

Fillit

1984

J American Geriatrics Society

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Although there are physiologic and anatomic changes of the kidney that occur almost universally with aging, no specific kidney disease that is totally confined to the geriatric population has been identified. Kidney diseases that predominate in the elderly include vascular and atheroembolic diseases, obstructive nephropathies, nephropathies secondary to certain systemic diseases, and intrinsic kidney disease. An understanding of the age-related changes of renal architecture and function is necessary to distinguish them from actual diseases that affect the aged kidney. These changes and their probable consequences for the geriatric patient are reviewed. We then discuss particular aspects of renal diseases that occur more commonly or have unique age-related manifestations in the elderly.

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“…In the majority of instances, atheroembolism is of little clinical significance since patients with this disease already suffer from advanced atherosclerosis. Nevertheless there are several described instances of clinical importance (Schornagel, 1961).…”

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confidence: 99%

Atheroembolism.

Kealy¹

1978

J Clin Pathol

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SUMMARY A review of the literature has shown that atheroembolism as a cause of clinically evident disease is an entity that is little documented. Sections of tissues from necropsies on patients over the age of 60 years from 1970 to 1977 inclusive were reviewed and examined for evidence of atheroembolism, and an incidence of 0 79 % was found. In every case of embolism the aorta showed advanced atheroma, sometimes with aneurysm formation. The ESR in some instances was increased, sometimes markedly so. Some of the problems of antemortem diagnosis are discussed. To emphasise the possible clinical importance of the condition, a rare instance of spinal cord infarction due to atheroembolism is described.

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Emboli of cholesterol crystals

Cited by 22 publications

References 8 publications

Atheromatous embolization

Atheromatous embolization

Renal Disease in the Geriatric Patient

Atheroembolism.

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