An Autopsy Case of Cholesterol Embolism Following Percutaneous Transluminal Coronary Angioplasty and Aortography

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Abstract
A 67-year-old woman with a 6-year history of angina pectoris underwent percutaneous transluminal coronary angioplasty. Just after manipulation of the guiding catheter during a second attempt at angioplasty and aortography, the patient developed intestinal obstruction with peritonitis. Laparotomy was performed, and surgical specimens taken during surgery revealed necrosis and perforation of the small intestine. Microscopical examination proved that this was the result of multiple fresh cholesterol emboli in the arteries. Postoperatively, renal failure and sepsis developed, and the patient died 13 days after surgery. Autopsy revealed multiple cholesterol emboli in arteries of the intestine, spleen, pancreas, liver and kidneys. This case demonstrates that cholesterol embolism can be a serious complication of percutaneous transluminal coronary angioplasty.