Fatal lipid embolism following intraarterial angiography at an early stageof arteriosclerosis

Intraarterial angiography was performed on a patient with peripheral arteri al occlusive disease (Fontaine IIb). No relevant risk factors were known, a nd a previous angiography had been undertaken without incident. After admin istration of contrast medium, the patient complained of acute pain in the l ower abdomen and both legs, and a sudden rise in blood pressure was observe d. The patient subsequently lost consciousness and died within 1.5 h. Postm ortem examination showed that death was due to peripheral atheromatous micr oembolism of lipids, and not cholesterol as is usual in these cases. The di fferential diagnosis is discussed and a review of the literature is present ed.