CHOLESTEROL EMBOLIZATION AFTER THROMBOLYTIC THERAPY

Cholesterol embolisation has been reported in 27 patients receiving th rombolytic therapy for acute myocardial infarction (MI). Since cholest erol embolisation is so difficult to diagnose ante mortem, it is possi ble that these cases represent the 'tip of the iceberg', and that chol esterol embolisation in this setting is far more common than usually s uspected. However, the risks of cholesterol embolisation are far outwe ighed by the survival benefits of thrombolytic therapy in patients wit h MI. Nevertheless, clinicians should maintain a high level of suspici on when clinical manifestations suggestive of cholesterol embolisation appear after thrombolytic therapy, as the risk of morbidity and morta lity can be high.