Thrombolytics can cause cholesterol embolization syndrome (CES). This
adverse effect has received less attention than other risks of thrombo
lytic therapy, such as systemic bleeding and hemorrhage, with only spo
radic reports of CES in the literature. Risk factors have not been con
sistently identified and emphasized; therefore, occurrence of CES afte
r thrombolysis remains difficult to predict, it results in substantial
morbidity and mortality, and it lacks effective pharmacologic treatme
nt. Heightened awareness of the disorder can aid in its correct identi
fication and reporting.