Cholesterol embolization: a complication of angiography

Cholesterol embolization is not widely recognized as a complication of major arteriographic procedures. In a retrospective study of 71 autopsies of patients who underwent diagnostic arteriographic procedures (20 with aortograms, 51 with cardiac catheterization and coronary angiography), we found an incidence of cholesterol embolization of 30% and 25.5%, respectively, in comparison with 4.3% in an age and disease-matched control population. The organs most frequently affected are the kidney and spleen following aortogram, and the myocardium following cardiac catheterization. The clinical importance of these findings cannot be ascertained from this study, but our experience with a single case demonstrates that radiographic studies may produce substantial morbidity.