Journal of the Neurological Sciences
Volume 222, Issue 1 , Pages 109-112 , 15 July 2004

Renal cholesterol embolism in patients with carotid stenosis: a severe and underdiagnosed complication following cerebrovascular procedures

  • Noriko Hagiwara

      Affiliations

    • Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, 1-8-1 Jigyohama, Chuou, Fukuoka 810-8563, Japan
    • ,
  • Kazunori Toyoda

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: +81-92-852-0700; fax: +81-92-847-8802.
    • Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, 1-8-1 Jigyohama, Chuou, Fukuoka 810-8563, Japan
    • ,
  • Masaru Nakayama

      Affiliations

    • Department of Nephrology, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, Fukuoka 810-8563, Japan
    • ,
  • Tooru Inoue

      Affiliations

    • Department of Neurosurgery, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, Fukuoka 810-8563, Japan
    • ,
  • Kotaro Yasumori

      Affiliations

    • Department of Neuroradiology, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, Fukuoka 810-8563, Japan
    • ,
  • Setsuro Ibayashi

      Affiliations

    • Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
    • ,
  • Yasushi Okada

      Affiliations

    • Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, 1-8-1 Jigyohama, Chuou, Fukuoka 810-8563, Japan

Received 4 November 2003 ,Revised 4 March 2004 ,Accepted 6 April 2004.

References 

  1. Scolari F, Tardanico R, Zani R, et al.  Cholesterol crystal embolism: a recognizable cause of renal disease. Am. J. Kidney Dis. 2000;36:1089–1109
  2. Balenfant Z, Meyrier A, Jacquot C. Supportive treatment improves survival in multivisceral cholesterol crystal embolism. Am. J. Kidney Dis. 1999;33:135–138
  3. Fine MJ, Kapoor W, Falanga V. Cholesterol crystal embolization: a review of 221 cases in the English literature. Angiology. 1987;42:769–784
  4. Cross SS. How common is cholesterol embolism?. J. Clin. Pathol. 1991;44:859–861
  5. Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A  Takeshita A for the Cholesterol Embolism Study (CHEST) Investigators . The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study. J. Am. Coll. Cardiol. 2003;42:211–216
  6. Amarenco P, Duyckaerts C, Tzourio C, Henin D, Bousser MG, Hauw JJ. The prevalence of ulcerated plaques in the aortic arch in patients with stroke. N. Engl. J. Med. 1992;326:221–225
  7. Masuda J, Yutani C, Ogata J, Kuriyama Y, Yamaguchi T. Atheromatous embolism in the brain: a Clinicopathologic analysis of 15 autopsy cases. Neurology. 1994;44:1231–1237
  8. Reil T, Shekherdimian S, Golchet P, Moore W. The safety of carotid endarterectomy in patients with preoperative renal dysfunction. Ann. Vasc. Surg. 2002;16:176–180
  9. Flory CM. Emboli from atheromatous plaque. Am. J. Pathol. 1945;21:549–565
  10. Eggebrecht H, Oldenburg O, Dirsch O, et al.  Potential embolization by atherosclerotic debris dislodged from aortic wall during cardiac catheterization: histological and clinical findings in 7,621 patients. Catheter. Cardiovasc. Interv. 2000;49:389–394
  11. Kasinath BS, Lewis EJ. Eosinophilia as a clue to the diagnosis of Atheroembolic renal disease. Arch. Intern. Med. 1987;147:1384–1385
  12. Fabbian F, Catalano C, Lambertini D, Bordin V, Di Landro D. A possible role of corticosteroids in cholesterol crystal embolization. Nephron. 1999;83:189–190
  13. Hasegawa M, Kawashima S, Shikano M, et al.  The evaluation of corticosteroid therapy in conjunction with plasma exchange in the treatment of renal cholesterol embolic disease. A report of 5 cases. Am. J. Nephrol. 2000;20:263–267
  14. Woolfson RG, Lachmann H. Improvement in renal cholesterol emboli syndrome after simvastatin. Lancet. 1998;351:1331–1332

PII: S0022-510X(04)00103-0

doi: 10.1016/j.jns.2004.04.003

Journal of the Neurological Sciences
Volume 222, Issue 1 , Pages 109-112 , 15 July 2004

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