Key result
A 73-year-old man developed cholesterol crystal embolism, manifesting as blue toe syndrome and acute kidney injury, four weeks after undergoing mechanical thrombectomy for an acute ischemic stroke.
Case Report (n=1)
No
Cholesterol crystal embolism is a rare but serious complication that can occur following mechanical thrombectomy for acute ischemic stroke, requiring high clinical suspicion if renal dysfunction or peripheral ischemia develops.
May warrant suspicion for cholesterol crystal embolism post-thrombectomy with AKI or blue toe; single case leaves open incidence and management questions.
Cholesterol crystal embolism (CCE) is a rare but serious complication of atherosclerotic plaque rupture, often occurring after endovascular interventions. We report the case of a 73-year-old man who developed CCE following mechanical thrombectomy (MT) for an acute ischemic stroke (AIS) due to left internal carotid artery occlusion. The patient, with a history of hypertension and hyperlipidemia, underwent successful MT with complete recanalization. However, four weeks after the procedure, he presented with blue toe syndrome and acute kidney injury. Histopathological analysis of a skin biopsy confirmed the diagnosis of CCE. The patient's renal function partially improved with corticosteroid therapy. Clinicians should maintain a high level of suspicion for CCE in patients who develop renal dysfunction or peripheral ischemia after MT, particularly in those with significant atherosclerotic risk factors. Early detection and timely intervention are critical for improving outcomes. Further research is warranted to clarify the incidence and optimal management of CCE in the context of MT for AIS.
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Kyaw et al. (2024) conducted a case report in Acute ischemic stroke and cholesterol crystal embolism (n=1). Mechanical thrombectomy was evaluated. A 73-year-old man developed cholesterol crystal embolism, manifesting as blue toe syndrome and acute kidney injury, four weeks after undergoing mechanical thrombectomy for an acute ischemic stroke.
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