Takahashi S, Komatsu S, Yutani C, Takewa M, Ohara T, Kodama K. Atherosclerosis of the aorta before blue toe syndrome: Spontaneously ruptured aortic plaques revealed by non-obstructive general angioscopy.
J Cardiol Cases 2023;
28:153-156. [PMID:
37818440 PMCID:
PMC10562127 DOI:
10.1016/j.jccase.2023.06.005]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/21/2023] [Accepted: 05/30/2023] [Indexed: 10/12/2023] Open
Abstract
A 50-year-old man who had undergone endovascular therapy 70 days previously was referred to us for the sudden onset of cyanosis with rest pain in the bilateral lower limbs. The patient was diagnosed with blue toe syndrome. Although computed tomography angiography showed irregular aortic wall thickness, preoperative aortic angioscopy detected a remarkable number of spontaneously ruptured aortic plaques, such as puff-chandelier ruptures, predominantly in the abdominal aorta. Continuous embolization of a large quantity of cholesterol crystals from puff-chandelier ruptures subsequently might be responsible for cholesterol embolization syndrome.
Learning objective
A patient presenting with cholesterol embolization syndrome had undergone a non-obstructive general angioscopy. We highlight the numerous spontaneously ruptured aortic plaques demonstrated by non-obstructive general angioscopy.
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