1/13. Retinal cholesterol emboli during diagnostic cardiac catheterization.Retinal embolism is a highly infrequent complication of cardiac catheterization of thrombotic, lipidic, and calcific etiology. We provide the first reported clinical case of retinal embolism caused by cholesterol crystal without systemic adverse effects as a severe complication of diagnostic cardiac catheterization. Cathet. Cardiovasc. Intervent. 51:323-325, 2000.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
2/13. Disseminated cholesterol embolism after coronary artery bypass grafting.blue toe syndrome caused by cholesterol emboli is a relatively benign disease. However, disseminated cholesterol embolism is a life-threatening condition. We describe here the case of a 71-year-old female admitted because of anterior chest pain and intermittent claudication. Following cardiac catheterization, warfarin potassium was administered. However, the patient's toes soon darkened bilaterally, and BUN and creatinine levels increased from the normal value. skin discoloration and renal failure were improved after stopping warfarin potassium administration. The patient underwent coronary artery bypass grafting and left femoropopliteal bypass. cerebral infarction and renal failure occurred postoperatively due to disseminated cholesterol embolism. The patient died from renal failure on the 16th postoperative day without regaining consciousness following surgery. For high risk patients, interventional procedures to the ascending aorta must be avoided. When CABG cannot be avoided for coronary revascularization, off-pump bypass and use of arterial grafts are recommended.- - - - - - - - - - ranking = 0.16666666666667keywords = catheterization (Clic here for more details about this article) |
3/13. cholesterol crystal embolization (CCE) after cardiac catheterization: a case report and a review of 36 cases in the Japanese literature.cholesterol crystal embolization (CCE) is a complication of atherosclerosis. A 67-year-old Japanese man underwent coronary artery bypass grafting. After the surgery, he underwent coronary angiography via the right femoral artery. Twelve days later, he suddenly developed acalculous cholecystitis and was treated with antibiotics. Gradual deterioration in renal function, purplish discoloration of the distal portion of his toes, and eosinophilia were noted. We performed a skin biopsy and made a diagnosis of CCE. Cilostazol and intravenous heparin improved the symptoms and decreased the creatinine level. We retrospectively studied the clinical features of 36 cases registered with a diagnosis of CCE in the Japanese literature.- - - - - - - - - - ranking = 0.66666666666667keywords = catheterization (Clic here for more details about this article) |
4/13. Shaggy aorta syndrome after acute arterial macroembolism: report of a case.We report the case of a patient who underwent treatment for a macroembolism in the right lower leg, which led to shaggy aorta syndrome. Anticoagulant therapy for the macroembolism and intra-aortic catheterization exacerbated the patient's renal function and triggered another massive microembolization of the visceral arteries, with a fatal outcome. To minimize the incremental complications inherent to this syndrome, awareness and prompt diagnosis with enhanced computed tomography or intravenous digital subtraction aortography are essential. Axillo-bifemoral bypass with bilateral external iliac artery ligations, performed with optimal timing, could save patients with shaggy aorta syndrome.- - - - - - - - - - ranking = 0.16666666666667keywords = catheterization (Clic here for more details about this article) |
5/13. Use of corticosteroids in the treatment of cholesterol crystal embolization after percutaneous transluminal coronary angioplasty and stent placement.cholesterol crystal embolization is a rare but recognized complication of cardiac catheterization. While management has traditionally been supportive only, we demonstrate the successful use of corticosteroids in treatment of a patient with cholesterol crystal embolization to the distal extremity.- - - - - - - - - - ranking = 0.16666666666667keywords = catheterization (Clic here for more details about this article) |
6/13. cholesterol embolism after cardiac catheterization mimicking infective endocarditis.We present a 65-year-old man with rheumatic combined valvular heart disease showing persistent fever 3 weeks after diagnostic cardiac catheterization. Infective endocarditis was strongly suspected from the clinical course, however, serial blood cultures were negative. Transesophageal echocardiography, done to investigate vegetation, revealed multiple mobile plaques in the descending aorta. Administration of both steroid and simvastatin improved both symptoms and renal function. cholesterol embolism should be considered to be one of the possible causes of low-grade fever after cardiac catheterization especially in patients with anticoagulation.- - - - - - - - - - ranking = 1keywords = catheterization (Clic here for more details about this article) |
7/13. Occult popliteal artery stenosis masquerading as atheroemboli in a patient with previous knee replacement.The purpose of this article is to report the unusual presentation of a 63-year-old patient with Rutherford grade 2, category 5 tissue ischemic changes involving the right foot secondary to an occult popliteal stenosis that was obscured behind a prosthetic knee on diagnostic angiograms. Conventional abdominal angiography with bilateral lower extremity runoff showed no evidence of significant disease and the patient was misdiagnosed with atheroemboli syndrome secondary to ipsilateral common femoral access following recent catheterization. Ultimately, a meticulous physical examination disclosed a bruit in the right popliteal fossa and selective right leg angiography with oblique views confirmed eccentric complex luminal encroachment in the right popliteal artery that was eclipsed by a prosthetic knee on antecedent nonselective angiography. The lesion responded favorably to endovascular treatment with durable clinical improvement. This case illustrates the importance of a meticulous physical examination and noninvasive studies prior to angiography in patients with ischemic tissue changes and emphasizes the importance of oblique views to image any vessel that may be obscured by a metal prosthesis.- - - - - - - - - - ranking = 0.16666666666667keywords = catheterization (Clic here for more details about this article) |
8/13. Multiple cholesterol emboli syndrome--six cases identified through the spontaneous reporting system.Six cases of suspected multiple cholesterol emboli syndrome were identified by a review of reports contained in the company's records of adverse event reports. Antecedent risk factors in these reports included cardiac catheterization, thrombolytic therapy, translumbar aortography, renal arteriography, subclavian arteriography, abdominal aortography, and heparinization. Unlike the commonly reported subacute presentation, onset occurred during or immediately after catheterization in 5 of the 6 patients reported. Acute renal failure; hypertension; back, leg, and/or abdominal pain; and livedo reticularis were the events most frequently reported. Angiographers should consider multiple cholesterol embolization when multiple organ system dysfunction occurs during or immediately after intraarterial catheterization.- - - - - - - - - - ranking = 0.5keywords = catheterization (Clic here for more details about this article) |
9/13. Transesophageal echocardiographically detected atherosclerotic aortic debris in a patient with systemic embolism following coronary angiography.Transesophageal echocardiography (TEE) has enabled detection of the cardiac source of systemic emboli. We report the case of a patient who manifested systemic, multiple embolization in the kidney, skin, and upper gastrointestinal tract following coronary angiography. TEE allowed visualization of the atherosclerotic debris in the thoracic aorta. The clinical picture of the patient was consistent with that of cholesterol embolism. We recommend that patients with extensive atherosclerotic disease should undergo TEE before cardiac catheterization or other invasive procedures involving the aorta are carried out.- - - - - - - - - - ranking = 0.16666666666667keywords = catheterization (Clic here for more details about this article) |
10/13. Atheromatous embolization resulting in acute pancreatitis after cardiac catheterization and angiographic studies.Acute pancreatitis has a spectrum from mild disease to severe organ destruction resulting in multiple system organ failure. In this study, we report data from 21,680 discharge summaries during a 10-year period of patients who had undergone transabdominal angiographic procedures in whom the diagnosis of pancreatitis was noted in the discharge coding. We detected 39 patients in whom pancreatitis was coded during the same hospitalization, but only nine patients had no other risk factors for pancreatitis other than the temporal relation with the angiographic procedure. Three of these nine patients died of complications caused by pancreatitis. All of the patients with poor outcomes in this report fulfilled more than three Ranson criteria within 48 hours of the original angiographic procedure. Abdominal imaging with ultrasound or computed tomography was abnormal in all the patients who fulfilled more than three Ranson criteria. The histology from the surgical procedures or the autopsies performed on the three patients who died showed extensive cholesterol embolization primarily to the visceral organs. Extensive pancreatic necrosis was evident in these patients. We conclude that acute pancreatitis after transabdominal angiographic procedures is a rare but a potential fatal event. The prognosis from this event is partially predicted by the Ranson criteria that are evident within the first 48 hours.- - - - - - - - - - ranking = 0.66666666666667keywords = catheterization (Clic here for more details about this article) |
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