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Q J Med 1999; 92: 341-346
© 1999 Association of Physicians

Aortic atherosclerotic debris detected by trans-oesophageal echocardiography—a risk factor for cholesterol embolization

W.P. Orr and A.P. Banning

From the Department of Cardiology, John Radcliffe Hospital, Oxford, UK

Received 13 November 1998 and in revised form 9 April 1999

Dr W.P. Orr, Department of Cardiology, John Radcliffe Hospital, Headington, Oxford. e-mail: william.orr{at}cardiov.ox.ac.uk

The clinical syndrome of cholesterol embolization is uncommon but is associated with a poor prognosis. Patients with severe atheromatous disease of the aorta appear to be at particular risk from cholesterol embolization, particularly following vascular instrumentation or surgery. Trans-oesophageal echocardiography is the investigation of choice for imaging atherosclerotic disease of the aorta, and may be useful in assessing the risk of vascular procedures, and diagnostically helpful in patients with suspected cholesterol emboli syndrome. We report five cases of athero-embolism, and illustrate the role of trans-oesophageal echocardiography in making a diagnosis of cholesterol embolization.


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