Renal cholesterol embolism in patients with carotid stenosis: a severe and underdiagnosed complication following cerebrovascular procedures.
Here, we report two cases with rapidly progressive renal failure, caused by cholesterol crystal embolism (CCE), after an angiography for carotid artery stenosis. The diagnosis was determined by histological examination and from clinical symptoms, including livedo reticularis and eosinophilia. Neurologists and neuroradiologists tend to underdiagnose CCE, which results from the same atherosclerotic risk factors as cerebrovascular disease. We need to understand more about CCE and identify its unique clinical symptoms to enable an early diagnosis and treatment.
Hagiwara
Noriko
N
Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, 1-8-1 Jigyohama, Chuou, Fukuoka 810-8563, Japan.
Toyoda
Kazunori
K
Nakayama
Masaru
M
Inoue
Tooru
T
Yasumori
Kotaro
K
Ibayashi
Setsuro
S
Okada
Yasushi
Y
D000368:Aged; D002339:Carotid Arteries / Q000473:pathology / Q000503:physiopathology; D016893:Carotid Stenosis / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D002533:Cerebral Angiography / Q000009:adverse effects*; D000075202:Contraindications; D003951:Diagnostic Errors / Q000517:prevention & control; D017700:Embolism, Cholesterol / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D016894:Endarterectomy, Carotid; D004802:Eosinophilia / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D012078:Renal Artery Obstruction / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D051437:Renal Insufficiency / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D012307:Risk Factors; D017445:Skin Diseases, Vascular / Q000209:etiology / Q000473:pathology / Q000503:physiopathology