抄録
The cases observed cholesterol emboli in arteries were found 38 cases (4.75%) out of 800 consecutive autopsy cases from June 1977 to October 1983 at National Cardiovascular Center. Average age in those cases was 69.8 years old and male: female ratio was 32: 6. All cases showed complicated lesion in atherosclerotic lesion, 19 cases (50%) of them were accompanied with aortic aneurysm. Hypertension was documented in 29 cases (76.3%) and diabetes mellitus 8 cases (21.1%).
Thirty-eight cases were divided into two groups by their pathoetiology, one is a group induced by definite etiology including cardiac catheterization (5 cases), intraaortic baloon pumping; IABP (4 cases), and surgical procedure (12 cases), the other is unknown etiology group (17 cases). Cardiac catheterization group was consisted with male with history of hypertension, but diabetes mellitus was only two cases. IABP group was also composed of cases with history of hypertension, and diabetes mellitus was seen in three cases. It is posturated that cholesterol embolization in definite etiology groups were not only due to mechanical injury onto the surface of aortic atherosclerotis, but also due to the cotrast (76% Urografin) and fibrinolytic therapy.
Embolization rate (organs observed cholesterol emboli/all organs examined) was as follows; cardiac catheterization group 61.8%, IABP group 63.9%, surgical procedure group 37.4%, unknown etiology group 55.1%. The kidney seemed to be most frequently affected, followed with diminishing frequency by the spleen, pancreas, liver, adrenal gland, stomach and brain. Infarction rate (infarcted organs/organs found cholesterol emboli) was as follows; cardiac catheterization group 82.4%, IABP group 44%, surgical procedure group 42.1%, and unknown etiology group 31.3%. From the aspect of organ affected by infarction, brain, spinal cord and gallbladder were 100% in definite etiology group, and in 38 cases followed with diminishing frequency by the brain, intestine, stomach, gallbladder, kidney, spinal cord, and spleen.
