Volume 72 Number 5 September 2005	back to contents

From the 1Department of Medicine, Hadassah University Hospital, and 2Department of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel.

Address all correspondence to Tal Grenader, M.D., Department of Medicine, Hadassah University Hospital, P.O. Box 12000, 91120 Jerusalem, Israel; e-mail: talgrenader65@hotmail.com

Accepted for publication January 2005.

ABSTRACT

Cholesterol embolism is a serious disease with a high morbidity and mortality rate. There is no clear evidence that any specific treatment helps this syndrome. We report a patient who developed acute renal failure due to cholesterol crystal embolism following percutaneous transluminal angioplasty of a renal artery. Treatment with iloprost for peripheral symptoms of cholesterol emboli resulted in rapid resolution of toe cyanosis, decrease in leg pain and a significant decrease in serum creatinine shortly after initiation of treatment. One month after initiation of iloprost therapy, skin signs of cholesterol emboli disappeared and leg pain diminished. Gradually reduction in serum creatinine level was also observed (from 390 to 160 micromol/L). Eighteen months after the arteriography, the patient had stable renal function with creatinine levels of 150–160 micromol/L, and he was asymptomatic.

KEY WORDS

Cholesterol crystal emboli, iloprost, acute renal failure.

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