Key result
PCI linked to cholesterol embolization syndrome presenting as ischemic stroke, AKI, and cutaneous changes.
Why the study?
Cholesterol embolization syndrome is an underdiagnosed cause of morbidity and mortality after invasive coronary interventions, and only few cases manifesting as ischemic stroke have been reported.
Case Report (n=1)
No
This case highlights that cholesterol embolization syndrome following PCI can rarely manifest as an ischemic stroke, requiring high clinical suspicion.
Post-PCI stroke with AKI and skin changes warrants consideration of cholesterol embolization; single case leaves open incidence and prevention data.
Cholesterol embolization syndrome (CES) is one of the major, yet underdiagnosed cause of morbidity and mortality following invasive coronary interventions. The major risk factors are elderly, male, atherosclerotic disease, anticoagulation and femoral access route. This multisystem disease affects skin, kidney, brain, eye and gastrointestinal tract. Only few cases of cholesterol embolization syndrome manifesting as an ischemic stroke are reported. We present a case of an elderly man, admitted to our ICU after percutaneous coronary intervention (PCI) who developed neurological deficits along with skin changes and renal failure. cholesterol embolization syndrome was suspected based upon the presence of cardiovascular risk factors, invasive cardiovascular intervention and clinical signs. The diagnosis of ischemic stroke made through plain MRI brain, revealed multiple areas of lacunar infarcts. He was treated with intermittent hemodialysis, statins and anti-platelet agents. On follow up, skin lesions and renal functions were improved; but slurring of speech and paresis persisted.
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Ghimire et al. (2021) conducted a case report in Cholesterol embolization syndrome (n=1). Percutaneous coronary intervention was evaluated on Clinical presentation of cholesterol embolization syndrome. A 70-year-old man developed cholesterol embolization syndrome manifesting as an ischemic stroke, acute kidney injury, and cutaneous changes following percutaneous coronary intervention.
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