Cholesterol emboli syndrome

The cholesterol emboli syndrome is a multi-system disease which may complicate:

• arteriography
• thrombolysis
• anticoagulation
• vascular surgery

The characteristic clinical triad is:

• livedo reticularis
• renal failure
• eosinophilia

Multiple treatment regimens have been generally unsuccessful in altering the course of the disease process. The most significant impact on the disease can be made by its prevention

• thrombolytic and anticoagulant treatments are not indicated and only supportive care for such symptoms as hypertension, ulceration, and gangrene is advocated
• prognosis depends on the extent of the systemic disease and a high rate of mortality (75–80%) is recorded due to multifactorial, cardiac, and renal aetiologies
• prognosis is poor with high mortality and the treatment is only supportive

Reference:

• Heart 2003;89:e17 (http://www.heartjnl.com/cgi/content/full/89/5/e17)
• Scolari F, Ravani P, Gaggi R, et al. (July 2007). The challenge of diagnosing atheroembolic renal disease: clinical features and prognostic factors. Circulation 116 (3): 298–304.