Cholesterol crystal embolization (CCE) after cardiac catheterization: a case report and a review of 36 cases in the Japanese literature.

Kaoru Funabiki, Hiroshi Masuoka, Hiroyuki Shimizu, Yoshiharu Emi, Takuya Mori, Masaaki Ito, Takeshi Nakano

Journal: Japanese heart journal 2003;44(5):767-74

PMID: 14587658

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Abstract

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.

Address: Division of Internal Medicine, Ise General Hospital, Ise, Japan.

DOI: 10.1536/jhj.44.767

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MeSH Terms: Aged, Blue Toe Syndrome, Cardiac Catheterization, Cholecystitis, Cilostazol, Coronary Angiography, Coronary Artery Bypass, Coronary Disease, Embolism, Cholesterol, Eosinophilia, Fibrinolytic Agents, Heparin, Humans, Male, Renal Insufficiency, Retrospective Studies, Tetrazoles