Clinical characteristics and outcomes of Chinese patients with cholesterol crystal embolism after coronary intervention

Abstract

Background: Cholesterol crystal embolism (CCE) is a complication of atherosclerosis. Vascular surgery, vascular angiography, and anticoagulation have been identified as inciting factors. Hypothesis: This paper sought to analyze the clinical characteristics of patients with CCE after percutaneous coronary intervention. Methods: Six patients with atherosclerosis presenting with simultaneous occurrence of acute renal failure and peripheral ischemic changes were diagnosed with CCE and their clinical data were analyzed. Results: The average age of the patients was 72 years. Most had risk factors of atherosclerosis such as hypertension, diabetes, and smoking. The levels of serum creatinine increased progressively after coronary angiography. All patients had concomitant skin lesions, including blue toes. Cholesterol crystal emboli were found in arterioles by cutaneous biopsy in one patient. All patients received statins and two of these received dialysis therapy. Three patients died and three remained in chronic renal failure. Conclusion: Since CCE is a severe complication of coronary intervention, special attention should be paid to this disease.