Cholesterol crystal embolization exacerbated after the off-pump coronary artery bypass; report of a case
Iwakura, T.; Enomoto, S.; Yamamoto, K.; Sakamoto, T.; Okamura, H.
Kyobu Geka. Japanese Journal of Thoracic Surgery 57(6): 477-480
2004
ISSN/ISBN: 0021-5252 PMID: 15202268 Document Number: 570023
A 66-year-old man with left main trunk disease was treated under a diagnosis of acute myocardial infarction based on coronary angiography by off-pump coronary artery bypass (OPCAB). About 1 month after operation, his renal function deteriorated and purpura appeared on both feet, especially at the toe tips. In this case, steroid therapy was performed and the patient survived. Cholesterol embolism rarely occurs after angiographic procedure or cardiovascular surgery. In general, it is associated with high morbidity and mortality, but no optimal treatment has yet been developed. This underlines the importance of careful observation and skin biopsy for early diagnosis.