Cholesterol embolus
Atheroembolism after angiography or vascular surgery, the livedo, blue toes, eosinophilia and subacute AKI that give it away, how it differs from contrast nephropathy, and supportive management with a statin.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Cholesterol crystals break off ulcerated atheromatous plaque, usually in the aorta, and lodge in arterioles of 100 to 200 µm. The crystals trigger inflammation, then intimal fibrosis and occlusion.
- Think of it in an older male smoker with atherosclerosis who becomes unwell days to weeks after angiography, vascular surgery or starting anticoagulation.
- The classic triad: livedo reticularis or blue toes, subacute AKI, eosinophilia.
Loading the rest of the note…
Finished reading?
Sources
- Therapeutic Guidelines: Cardiovascular. Peripheral arterial diseaseAU/NZTherapeutic Guidelines Limited (eTG complete), current eTG edition (version not verified)
- Scolari F, Ravani P. Atheroembolic renal disease. Lancet 2010;375:1650-60The Lancet, 2010
- Scolari F et al. The challenge of diagnosing atheroembolic renal disease: clinical features and prognostic factors. Circulation 2007;116:298-304Circulation, 2007
- Fukumoto Y et al. The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study. J Am Coll Cardiol 2003;42:211-6Journal of the American College of Cardiology, 2003
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy