Atheromatous embolization.

Abstract

Atheromatous emboli occur spontaneously or may be secondary to surgery or trauma. Thurlbeck and Castleman found a 77% incidence of atheromatous emboli to the kidney following the surgical repair of abdominal aortic aneurysms. Atheromatous debris may be dislodged following aortography, renal arteriography, and left heart catheterization via the right femoral artery. External trauma, including hip fracture, external cardiac message, and blunt abdominal trauma have initiated peripheral atheromatous embolization. The incidence of this phenomenon may be higher than documented in the literature, since it is difficult to establish the diagnosis prior to death. Atheromatous emboli should be suspected clinically in elderly patients with sudden onset of pain and ischemia of the lower extremities or unexplained renal failure. At the present time, multiple atheromatous emboli may be treated symptomatically only. Muscle biopsy, retinal examination, and kidney biopsy may be used to differentiate atheromatous embolization from other clinical entities.