Risk Factors for Cholesterol Embolization After Catheterization

Embolization of cholesterol crystals from aortic atheromatous plaques, a complication of cardiac catheterization, can result in renal failure, cutaneous involvement (e.g., livedo reticularis), and multi-organ failure. Mortality rates from cholesterol embolization syndrome (CES) can reach 70%. In a multicenter Japanese study, researchers prospectively determined CES incidence and risk factors in 1786 consecutive patients (mean age, 65) who underwent catheterization.

Definite or possible CES was diagnosed in 25 patients (1.4%). Preprocedure and postprocedure blood eosinophil counts were significantly higher in patients with postprocedure CES than in those without CES; after catheterization, 20% of patients with CES and 3% of patients without C…