Overview
Cholesterol Embolism is a medical condition which occurs when a chunk of cholesterol breaks away from the lining of an artery and travels through the bloodstream, ultimately impeding the flow of blood. Because the chunk of cholesterol can potentially end up anywhere in the body, the symptoms and complications associated with a cholesterol embolism are incredibly varied, and the condition can sometimes be difficult to diagnose.The most common cause of a cholesterol embolism is a medical procedure which involves the blood vessels or arteries, as such procedures can loosen plaques of cholesterol, potentially creating a situation where a chunk could break off. Emboli are also associated with certain medications, and they are more common in the elderly, especially among Caucasians. While it is rare for a cholesterol embolism to occur spontaneously, this will occasionally happen, and it can sometimes impede the diagnosis.
Causes
Any risk factor for Atherosclerotic Disease is a risk factor for cholesterol embolism. Preoperative risk factors for cholesterol embolism syndrome after coronary artery bypass surgery include being older than 60 years, hypertension, cerebrovascular disease, aortoiliac disease, and mitral annular calcification. Although the other factors are well known, the association between mitral annular calcification and aortic atherosclerosis was identified only recently.
Identifying patients at risk and making efforts to minimize aortic wall trauma help reduce the chance of cholesterol embolism. The risk for a patient developing cholesterol embolism may be reduced by using a brachial or axillary approach in patients known to have severely ulcerated aortic plaque, using soft flexible catheters, and avoiding high-pressure jets of contrast material.
Risk Factors
- Atherosclerotic cardiovascular disease, history of MI (myocardial infarction)
- Anticoagulation and perhaps thrombolytic therapy – perhaps because overlying thrombi do not form over eroded plaques
- Cardiopulmonary resuscitation
- Hypertension
- Aortic aneurysm
- Hypercholesterolemia
- Smoking history
- Male sex
- Age over 55 years
- Vascular procedures
- Invasive angiography, including interventional cardiac catheterizations
- Aortic aneurysm rupture or surgery
- Vascular surgery
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