Visual disturbance due to carotid artery thrombosis in a patient with familial hypercholesterolemia; Response to surgical thrombotectomy

A 48 years-old Japanese man suffered from marked xanthomas on ankles, knees , hand fingers, and foot joints due to insufficient control of serum hyperc holesterolemia despite low density lipoprotein (LDL-C) absorptive therapy f ollowed by treatment with potent anti-hypercholesterolemic agents. He had u ndergone surgical resection of xanthoma on the knee, foot and hand finger j oints. Treatment with simvastatin returned the serum total cholesterol leve ls to nearly normal levels, followed by marked fluctuations. He subsequentl y experienced transient right-visual disturbance, and roentogenographic exa mination was performed. The patient was diagnosed as right-common carotid a rtery thrombosis. After the thrombotectomy of the right-common carotid arte ry, his visual power was markedly improved.