1. The Seabed-like Appearance of Atherosclerotic Plaques: Three-Dimensional Transesophageal Echocardiographic Images of the Aortic Arch Causing Cholesterol Crystal Emboli
- Author
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Akihiko Nakano, Koji Kurosawa, Masahiko Kurabayashi, Masahiro Nakajima, Hiroko Tsuchiya, Kazuaki Negishi, Kosaku Goto, Nobuaki Fukuda, and Rieko Takahashi
- Subjects
Male ,Aortic arch ,medicine.medical_specialty ,medicine.medical_treatment ,Echocardiography, Three-Dimensional ,Myocardial Infarction ,Contrast Media ,Aorta, Thoracic ,Coronary Angiography ,Risk Assessment ,Nephropathy ,Angioplasty ,medicine.artery ,Internal medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Myocardial infarction ,Emergency Treatment ,Embolism, Cholesterol ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Acute Kidney Injury ,medicine.disease ,Plaque, Atherosclerotic ,Treatment Outcome ,Atheroma ,Embolism ,Creatinine ,Skin biopsy ,Disease Progression ,Cardiology ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Complication ,human activities ,Echocardiography, Transesophageal ,Follow-Up Studies - Abstract
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.
- Published
- 2010
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