KUMJ | VOL. 19 | NO. 1 | ISSUE 73 | JAN.-MARCH, 2021
Ischemic Stroke as a Manifestation of Cholesterol Embolization Syndrome Following Percutaneous Coronary Intervention
Ghimire B, Khanal K, Bajracharya A, Koirala M
Abstract: 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.
Keyword : Cholesterol embolization syndrome, Ischemic stroke, Percutaneous coronary intervention
