The Seabed-like Appearance of Atherosclerotic Plaques: Three-Dimensional Transesophageal Echocardiographic Images of the Aortic Arch Causing Cholesterol Crystal Emboli

Cholesterol crystal embolism (CCE) is a rare but important complication of endovascular procedures or anticoagulation therapy. An 84-year-old man was referred to the Gunma University Graduate School of Medicine with the diagnosis of acute myocardial infarction. After successful emergency coronary an...

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Veröffentlicht in:	Journal of the American Society of Echocardiography 2010-11, Vol.23 (11), p.1222.e1-1222.e4
Hauptverfasser:	Negishi, Kazuaki, MD, Tsuchiya, Hiroko, MD, Nakajima, Masahiro, MD, Goto, Kosaku, MD, Kurosawa, Koji, MD, Fukuda, Nobuaki, MD, Takahashi, Rieko, MD, Nakano, Akihiko, MD, Kurabayashi, Masahiko, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Acute Kidney Injury - chemically induced Acute Kidney Injury - diagnostic imaging Aged, 80 and over Angioplasty - methods Aorta, Thoracic - diagnostic imaging Aortic arch Atherosclerosis Cardiovascular Cholesterol crystal embolization Contrast Media - adverse effects Coronary Angiography - methods Creatinine - blood Disease Progression Echocardiography, Three-Dimensional - methods Echocardiography, Transesophageal - methods Embolism, Cholesterol - diagnostic imaging Embolism, Cholesterol - physiopathology Emergency Treatment Endovascular Procedures - adverse effects Endovascular Procedures - methods Follow-Up Studies Humans Male Myocardial Infarction - diagnostic imaging Myocardial Infarction - therapy Plaque Plaque, Atherosclerotic - diagnostic imaging Plaque, Atherosclerotic - therapy Risk Assessment Three-dimensional transesophageal echocardiography Treatment Outcome
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Zusammenfassung:	Cholesterol crystal embolism (CCE) is a rare but important complication of endovascular procedures or anticoagulation therapy. An 84-year-old man was referred to the Gunma University Graduate School of Medicine with the diagnosis of acute myocardial infarction. After successful emergency coronary angioplasty, his serum creatinine level increased continuously. A subsequent skin biopsy confirmed that the patient had CCE. Transesophageal echocardiography (TEE) clearly demonstrated the mobile mass protruding from the complex atheroma. Three-dimensional TEE provides more precise and attractive volumetric images of the atherosclerotic plaque than two-dimensional TEE. In addition, the findings of this case revealed contrast media-induced nephropathy and CCE as possible causes of renal dysfunction after endovascular procedures.
ISSN:	0894-7317 1097-6795
DOI:	10.1016/j.echo.2010.04.003