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Disseminated cholesterol crystal emboli |
Sang Thrombose Vaisseaux. Volume 10, Number 9, 573-80, Novembre 1998, Mini-revues
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 Résumé
Article gratuit
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Author(s) : Xavier BELENFANT, Christian JACQUOT, Christian D'AUZAC DE LAMARTINIE |
Summary : Cholesterol crystal embolisation from disrupted atherosclerotic plaques is probably frequent. Post-mortem prevalence of cholesterol crystal embolisation is 0.31-4% in an unselected population, 30% after arterial angiography, 77% after aortic grafting. Moreover, symptomatic cholesterol crystal embolisation is quite infrequent, but severe. It is often iatrogenic and induced by arterial angiography, anticoagulant or thrombolytic therapy, and cardiac or vascular surgery. Clinical diagnosis is often delayed. It is observed more often in male patients with severe and symptomatic atherosclerosis disease presenting with subacute renal failure, cardiac failure, gastrointestinal ischemia, and cutaneous ischemia. Retinal crystal cholesterol can confirm cholesterol crystal embolisation diagnosis, but its prevalence is low. Laboratory data are not discrimining. Eosinophilia is quite frequent. In recent years, prognosis of disseminated cholesterol crystal embolisation has been improved by a strict pathophysiological and symptomatic treatment schedule. One-year mortality rate has declined from 81% to 23%. Survival after acute cholesterol crystal embolisation disease is similar to that of patients with severe and symptomatic atherosclerosis. |
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