Retinal cholesterol emboli during diagnostic cardiac catheterization

Blanco, Víctor María Fernández; Morı́s, César; Barriales, Vicente; González, Carmen Martínez

doi:10.1002/1522-726x(200011)51:3<323::aid-ccd19>3.0.co;2-o

Cited by 8 publications

(9 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is true because the syndrome has two pathophysiological phases: an acute obstructive phase and a subacute inflammatory phase. Unless the obstructive phase causes immediate disability, such as in the case reported by Blanco and co-authors [1], most invasive cardiologists will not be aware that cholesterol embolization has taken place. The cholesterol crystals partially obstruct arterioles and produce a delayed inflammatory response over a period of several weeks, which is associated with endothelial proliferation, foreign-body reaction, and eosinophilia.…”

mentioning

confidence: 99%

Cholesterol embolization syndrome: Unifying principles

Bittl

2000

Cathet. Cardiovasc. Intervent.

View full text Add to dashboard Cite

mentioning

confidence: 99%

Cholesterol embolization syndrome: Unifying principles

Bittl

2000

Cathet. Cardiovasc. Intervent.

View full text Add to dashboard Cite

“…[9][10][11] Once a cholesterol embolism has been established, no effective specific treatment exists other than endarterectomy of the atherosclerotic carotid artery, if such a defect exists, to prevent recurrent embolic processes. 9) Patients who require catheterization but have noninvasive evidence of atherosclerotic aortic debris most likely should undergo an upper extremity approach, to reduce the likelihood of cholesterol embolization. 10,11) In high-risk patients, such as the elderly, noninvasive procedures (transesophageal echocardiography, magnetic resonance imaging, computed tomography, etc.)…”

Section: Discussionmentioning

confidence: 56%

“…It is produced when cholesterol crystals from an ulcerated, disrupted atheromatous plaque, frequently localized in the internal carotid artery or near the origin of the aorta, are released in the arterial bloodstream and often results in multiorgan systemic failure symptoms characterized by skin lesions, lowerextremity ischemia, renal insufficiency, arterial hypertension, gastrointestinal bleeding and retinal embolism, among others. 9) In our case, she only had a visual problem without other systemic adverse effects. Arterial procedures (surgery and cardiac catheterization) as well as pharmacologic treatment with an anticoagulant, such as warfarin or heparin, and fibrinolytic agents have been described as the precipitating factors, because they may prevent the formation of thrombi over ulcerated atheromatous plaques, allowing exposed cholesterol crystals to be scraped into the circulation.…”

Section: Discussionmentioning

confidence: 99%

“…Arterial procedures (surgery and cardiac catheterization) as well as pharmacologic treatment with an anticoagulant, such as warfarin or heparin, and fibrinolytic agents have been described as the precipitating factors, because they may prevent the formation of thrombi over ulcerated atheromatous plaques, allowing exposed cholesterol crystals to be scraped into the circulation. [9][10][11] Once a cholesterol embolism has been established, no effective specific treatment exists other than endarterectomy of the atherosclerotic carotid artery, if such a defect exists, to prevent recurrent embolic processes. 9) Patients who require catheterization but have noninvasive evidence of atherosclerotic aortic debris most likely should undergo an upper extremity approach, to reduce the likelihood of cholesterol embolization.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Branch Retinal Artery Occlusion after Diagnostic Cardiac Catheterization.

Chan

Ueng

et al. 2002

Jpn Heart J

View full text Add to dashboard Cite

SUMMARYA case of right branch retinal artery occlusion (BRAO) due to cholesterol-containing embolus following transfemoral cardiac catheterization is reported. It is extremely rare, however, cardiologists should be alert to any thromboembolic complications during and following cardiac catheterization and choose the suitable approach (either upper extremity or transfemoral). (Jpn Heart J 2002; 43: 193-196) Key words: Branch retinal artery occlusion, Cardiac catheterization DIAGNOSTIC coronary catheterization may result in complications, such as neurologic events (stroke, transient ischemic attack, 0.1%), arrythmias (0.3%), local vascular problems (1.6%), vasovagal reactions (2.1%), and allergy (0.1~2%).1) The incidence of systemic cholesterol emboli after a percutaneous transluminal coronary angioplasty was reported to be 1.4-3%.2) However, ocular complications are extremely rare after simple diagnostic cardiac catheterization. We report a case of branch retinal artery occlusion following transfemoral cardiac catheterization. CASE REPORTA 79-year-old Taiwanese female was admitted because of a sudden onset of chest tightness, which was responsive to sublingual nitroglycerin. She had hypertension for more than 10 years with regular treatment. She had no history of diabetes mellitus, hyperlipidemia, or smoking. Echocardiography revealed a calcified aortic valve and normal left ventricular function. No obvious intracardiac vegetation or thrombus was seen. Tl-201 stress/redistribution myocardial perfusion single photon emission computed tomography revealed possible mild From the

show abstract

“…Los émbolos de colesterol (placas de Hollenhorst) son de color blanco-amarillento y pueden localizarse en la arteria central de la retina, sus ramas principales (3), distales o en arteria ciliorretiniana (4,5). A veces los procesos obstructivos en el CES pueden mostrarse en el fondo ocular solo como microhemorragias (4).…”

Section: Discussionunclassified

Embolismos retinianos por colesterol tras angiografía coronaria

Sampedro

Pinto

Guerediaga

et al. 2006

Arch Soc Esp Oftalmol

View full text Add to dashboard Cite

RESUMENCaso clínico: Se presenta un paciente con múltiples embolismos retinianos por colesterol en ambos ojos, tras una coronariografía. Asociaba además, manifestaciones renales, cutáneas y cardíacas del Síndrome de Embolismo por Colesterol (CES), falleciendo a las 10 semanas. La autopsia confirmó la presencia de cristales de colesterol en múltiples órganos. Discusión: Las placas ateromatosas, durante un procedimiento invasivo arterial, pueden ser origen de embolizaciones masivas por colesterol. La presencia de émbolos retinianos ayuda al diagnóstico del síndrome, sobre todo cuando se acompaña de sintomatología sistémica. El pronóstico vital es malo por la insuficiencia multiorgánica.Palabras clave: Embolismo retiniano, colesterol, ateroma, angiografía coronaria, diagnóstico. COMUNICACIÓN CORTA ABSTRACTCase report: We report a patient with multiple cholesterol retinal embolism in both eyes following coronary angiography. She also had associated renal, skin and cardiac manifestations of the Cholesterol Embolization Syndrome (CES) and died 10 weeks later. Autopsy revealed cholesterol crystal emboli in several organs. Discussion: Atheromatous plaques can be ruptured and displaced during a diagnostic catheterisation, and thus can be a potential source of these massive emboli. Retinal cholesterol crystals help to establish the diagnosis of the syndrome, particularly when other systemic manifestations exist. When this complication occurs, the prognosis can be devastating because of associated multiorgan failure (Arch Soc Esp Oftalmol 2006; 81: 413-416).

show abstract

Retinal cholesterol emboli during diagnostic cardiac catheterization

Cited by 8 publications

References 5 publications

Cholesterol embolization syndrome: Unifying principles

Cholesterol embolization syndrome: Unifying principles

Branch Retinal Artery Occlusion after Diagnostic Cardiac Catheterization.

Embolismos retinianos por colesterol tras angiografía coronaria

Contact Info

Product

Resources

About