Cholesterol embolism as a complication of left heart catheterisation. Report of seven cases.
Cholesterol embolism as a complication of left heart catheterisation. Report of seven cases.
复制标题
胆固醇栓塞是左心导管插入术的并发症。
作者：
H. Drost;B. Buis;D. Haan;J. Hillers
在总共4587例导尿术中，有7名男性(平均年龄59.6岁)被诊断为经股动脉插管后发生胆固醇栓塞。有4名患者出现糖尿病，3名患者出现系统性高血压，6名患者出现广泛的动脉粥样硬化迹象；5名患者正在服用抗凝药物。6名患者出现急性腿部或腹部疼痛，其中2名患者出现腹痛；6名患者出现肾功能衰竭，5名患者出现皮肤症状，1名患者视网膜出现胆固醇栓子。六名患者中有六名患者的血沉明显增加，五名患者中有五名在导尿后一周内出现嗜酸性粒细胞增多症。5名患者进展为肾功能衰竭，其中一名患者需要血液透析。三名患者因坏疽而接受了脚趾截肢。四名患者在插管后四个半月内死于与胆固醇栓塞没有直接关系的原因。在尸检中，所有四名患者都发现了胆固醇栓子。胆固醇栓塞是左心导管术的一种罕见但严重的并发症。
Cholesterol embolism after left heart catheterisation by the femoral approach was diagnosed in seven men (mean age 59.6 years) out of a total of 4587 catheterisations. Diabetes was present in four patients, systemic hypertension in three, and signs of extensive atherosclerosis in six; five patients were taking anticoagulant drugs. Acute pain in the legs or abdomen occurred in six patients, two of whom had abdominal angina; renal failure was present in six patients, cutaneous manifestations in five, and a cholesterol embolus was seen in the retina in one. Six out of six patients had an appreciable increase in the erythrocyte sedimentation rate and five out of five had eosinophilia within a week of catheterisation. Renal failure was progressive in five patients, one of whom required haemodialysis. Three patients required amputation of the toes because of gangrene. Four patients died within four and a half months of catheterisation from causes not directly related to cholesterol embolism. At necropsy cholesterol emboli were found in all four patients. Cholesterol embolism is a rare but serious complication of left heart catheterisation.