37. Harloff A, Simon J, Brendecke S, et al. Complex plaques in the proximal descending aorta: an underestimated embolic source of stroke. Stroke 2010; 41:1145. 38. Tanaka H, Yamana H, Matsui H, et al. Proportion and risk factors of cholesterol crystal embolization after cardiovascular procedures: a retrospective national database study. Heart Vessels 2020; 35:1250. 39. Pandit AK, Ohshima T, Kawaguchi R, et al. Cholesterol Embolization Syndrome After Carotid Artery Stenting Associated with Delayed Cerebral Hyperperfusion Intracerebral Hemorrhage. World Neurosurg 2020; 142:274. 40. Rudnick MR, Berns JS, Cohen RM, Goldfarb S. Nephrotoxic risks of renal angiography: contrast media-associated nephrotoxicity and atheroembolism a critical review. Am J Kidney Dis 1994; 24:713. 41. Nishi T, Tokuda Y, Tanaka A, et al. Cholesterol Crystal Embolization After Transcatheter Aortic Valve Replacement. Circ Rep 2020; 2:701. 42. Khan AM, Jacobs S. Trash feet after coronary angiography. Heart 2003; 89:e17. 43. Keeley EC, Grines CL. Scraping of aortic debris by coronary guiding catheters: a prospective evaluation of 1,000 cases. J Am Coll Cardiol 1998; 32:1861. 44. Holden A, Hill A, Jaff MR, Pilmore H. Renal artery stent revascularization with embolic protection in patients with ischemic nephropathy. Kidney Int 2006; 70:948. 45. Edwards MS, Craven BL, Stafford J, et al. Distal embolic protection during renal artery angioplasty and stenting. J Vasc Surg 2006; 44:128. 46. Muller-Hansma AHG, Daemen-Gubbels CRGM, Schut NH. Cholesterol embolisms as possible adverse drug reaction of direct oral anticoagulants. Neth J Med 2018; 76:125. 47. Oka H, Kamimura T, Hiramatsu Y, et al. Cholesterol Crystal Embolism Induced by Direct Factor Xa Inhibitor: A First Case Report. Intern Med 2018; 57:71. 48. Glassock RJ, Ritz E, Bommer J, et al. Acute renal failure, hypertension and skin necrosis in a patient with streptokinase therapy. Am J Nephrol 1984; 4:193. 49. Hitti WA, Wali RK, Weinman EJ, et al. Cholesterol embolization syndrome induced by thrombolytic therapy. Am J Cardiovasc Drugs 2008; 8:27. 50. Nevelsteen A, Kutten M, Lacroix H, Suy R. Oral anticoagulant therapy: a precipitating factor in the pathogenesis of cholesterol embolization? Acta Chir Belg 1992; 92:33. 51. Hyman BT, Landas SK, Ashman RF, et al. Warfarin-related purple toes syndrome and cholesterol microembolization. Am J Med 1987; 82:1233. https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 23/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate 52. Transesophageal echocardiographic correlates of thromboembolism in high-risk patients with nonvalvular atrial fibrillation. The Stroke Prevention in Atrial Fibrillation Investigators Committee on Echocardiography. Ann Intern Med 1998; 128:639. 53. Blackshear JL, Zabalgoitia M, Pennock G, et al. Warfarin safety and efficacy in patients with thoracic aortic plaque and atrial fibrillation. SPAF TEE Investigators. Stroke Prevention and Atrial Fibrillation. Transesophageal echocardiography. Am J Cardiol 1999; 83:453. 54. Falanga V, Fine MJ, Kapoor WN. The cutaneous manifestations of cholesterol crystal embolization. Arch Dermatol 1986; 122:1194. 55. Olin JW. Other Peripheral Arterial Diseases. In: Goldman: Cecil Textbook of Medicine, 21st e d, WB Saunders, Philadelphia 2000. p.362. 56. Turakhia AK, Khan MA. Splinter hemorrhages as a possible clinical manifestation of cholesterol crystal embolization. J Rheumatol 1990; 17:1083. 57. Donohue KG, Saap L, Falanga V. Cholesterol crystal embolization: an atherosclerotic disease with frequent and varied cutaneous manifestations. J Eur Acad Dermatol Venereol 2003; 17:504. 58. Rosansky SJ. Multiple cholesterol emboli syndrome. South Med J 1982; 75:677. 59. Quintart C, Treille S, Lefebvre P, Pontus T. Penile necrosis following cholesterol embolism. Br J Urol 1997; 80:347. 60. Zhang WW, Chauvapun JP, Dosluoglu HH. Scrotal necrosis following endovascular abdominal aortic aneurysm repair. Vascular 2007; 15:113. 61. Zaveri S, Price LZ, Tupper H, Tadros RO. Atheroembolism to the Breast. Ann Vasc Surg 2020; 64:411.e17. 62. Mittal BV, Alexander MP, Rennke HG, Singh AK. Atheroembolic renal disease: a silent masquerader. Kidney Int 2008; 73:126. 63. Scolari F, Ravani P. Atheroembolic renal disease. Lancet 2010; 375:1650. 64. Sarwar S, Al-Absi A, Wall BM. Catastrophic cholesterol crystal embolization after endovascular stent placement for peripheral vascular disease. Am J Med Sci 2008; 335:403. 65. Grassia R, Manotti L, Pasin F. An Unusual Storm Within the Gastroduodenal Tract. Gastroenterology 2016; 151:243. 66. Tian M, Matsukuma KE. Cholesterol crystal embolism to the gastrointestinal tract: a catastrophic case. Autops Case Rep 2019; 9:e2018082. 67. Kadoya Y, Zen K, Takigami M, et al. Multiple Small Bowel Perforations Associated With Cholesterol Crystal Embolization After Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2020; 13:1831. https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 24/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate 68. Ben-Horin S, Bardan E, Barshack I, et al. Cholesterol crystal embolization to the digestive system: characterization of a common, yet overlooked presentation of atheroembolism. Am J Gastroenterol 2003; 98:1471. 69. Moolenaar W, Lamers CB. Cholesterol crystal embolization to liver, gallbladder, and pancreas. Dig Dis Sci 1996; 41:1819. 70. Moolenaar W, Lamers CB. Gastrointestinal blood loss due to cholesterol crystal embolization. J Clin Gastroenterol 1995; 21:220. 71. Bourdages R, Prentice RS, Beck IT, et al. Atheromatous embolization to the stomach: an unusual cause of gastrointestinal bleeding. Am J Dig Dis 1976; 21:889. 72. Abdelmalek MF, Spittell PC. 79-year-old woman with blue toes. Mayo Clin Proc 1995; 70:292. 73. Maekawa K, Shibata M, Nakajima H, et al. Cholesterol Crystals in Embolic Debris are Associated with Postoperative Cerebral Embolism after Carotid Artery Stenting. Cerebrovasc Dis 2018; 46:242. 74. Caplan LR. The aorta as a donor source of brain embolism. In: Brain embolism, Caplan, LR, Manning, WJ (Eds), Informa Healthcare, New York 2006. p.187. 75. Petty GW, Khandheria BK, Meissner I, et al. Population-based study of the relationship between atherosclerotic aortic debris and cerebrovascular ischemic events. Mayo Clin Proc 2006; 81:609. 76. Russo C, Jin Z, Rundek T, et al. Atherosclerotic disease of the proximal aorta and the risk of vascular events in a population-based cohort: the Aortic Plaques and Risk of Ischemic Stroke (APRIS) study. Stroke 2009; 40:2313. 77. Cohen A, Tzourio C, Bertrand B, et al. Aortic plaque morphology and vascular events: a follow-up study in patients with ischemic stroke. FAPS Investigators. French Study of Aortic Plaques in Stroke. Circulation 1997; 96:3838. 78. Di Tullio MR, Russo C, Jin Z, et al. Aortic arch plaques and risk of recurrent stroke and death. Circulation 2009; 119:2376. 79. Ezzeddine MA, Primavera JM, Rosand J, et al. Clinical characteristics of pathologically proved cholesterol emboli to the brain. Neurology 2000; 54:1681. 80. Gonzalez-Castellon M, Kadakia P, Willey J, et al. Teaching video neuroimages: Hollenhorst plaque. Neurology 2013; 81:e60. 81. HOLLENHORST RW. Significance of bright plaques in the retinal arterioles. JAMA 1961; 178:23. 82. Chawluk JB, Kushner MJ, Bank WJ, et al. Atherosclerotic carotid artery disease in patients with retinal ischemic syndromes. Neurology 1988; 38:858. https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 25/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate 83. Bunt TJ. The clinical significance of the asymptomatic Hollenhorst plaque. J Vasc Surg 1986; 4:559. 84. Dunlap AB, Kosmorsky GS, Kashyap VS. The fate of patients with retinal artery occlusion and Hollenhorst plaque. J Vasc Surg 2007; 46:1125. 85. Wijman CA, Babikian VL, Matjucha IC, et al. Cerebral microembolism in patients with retinal ischemia. Stroke 1998; 29:1139. 86. Babikian V, Wijman CA, Koleini B, et al. Retinal ischemia and embolism. Etiologies and outcomes based on a prospective study. Cerebrovasc Dis 2001; 12:108. 87. Kitamura N, Sasabe E, Kitaoka H, Yamamoto T. Unilateral necrosis of the tongue caused by embolisation of cholesterol crystals. Br J Oral Maxillofac Surg 2018; 56:340. 88. Thadhani RI, Camargo CA Jr, Xavier RJ, et al. Atheroembolic renal failure after invasive procedures. Natural history based on 52 histologically proven cases. Medicine (Baltimore) 1995; 74:350. 89. Cosio FG, Zager RA, Sharma HM. Atheroembolic renal disease causes hypocomplementaemia. Lancet 1985; 2:118. 90. Kasinath BS, Lewis EJ. Eosinophilia as a clue to the diagnosis of atheroembolic renal disease. Arch Intern Med 1987; 147:1384. 91. Wilson DM, Salazer TL, Farkouh ME. Eosinophiluria in atheroembolic renal disease. Am J Med 1991; 91:186. 92. Tunick PA, Krinsky GA, Lee VS, Kronzon I. Diagnostic imaging of thoracic aortic atherosclerosis. AJR Am J Roentgenol 2000; 174:1119. 93. Tenenbaum A, Garniek A, Shemesh J, et al. Dual-helical CT for detecting aortic atheromas as a source of stroke: comparison with transesophageal echocardiography. Radiology 1998; 208:153. 94. Khatri IA, Mian N, Alkawi A, et al. Catheter-based aortography fails to identify aortic atherosclerotic lesions detected on transesophageal echocardiography. J Neuroimaging 2005; 15:261. 95. Warren BA, Vales O. The ultrastructure of the stages of atheroembolic occlusion of renal arteries. Br J Exp Pathol 1973; 54:469. 96. Case records of the Massachusetts General Hospital. Weekly Clinicopathological Exercises. Case 11-1996. A 69-year-old man with progressive renal failure and the abrupt onset of dyspnea. N Engl J Med 1996; 334:973. 97. Smith SC Jr, Allen J, Blair SN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 26/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate National Heart, Lung, and Blood Institute. Circulation 2006; 113:2363. 98. Mann SJ, Sos TA. Treatment of atheroembolization with corticosteroids. Am J Hypertens 2001; 14:831. 99. Motegi S, Abe M, Shimizu A, et al. Cholesterol crystal embolization: skin manifestation, gastrointestinal and central nervous symptom treated with corticosteroid. J Dermatol 2005; 32:295. 100. Matsumura T, Matsumoto A, Ohno M, et al. A case of cholesterol embolism confirmed by skin biopsy and successfully treated with statins and steroids. Am J Med Sci 2006; 331:280. 101. Koga J, Ohno M, Okamoto K, et al. Cholesterol embolization treated with corticosteroids two case reports. Angiology 2005; 56:497. 102. Y cel AE, Kart-K seoglu H, Demirhan B, Ozdemir FN. Cholesterol crystal embolization mimicking vasculitis: success with corticosteroid and cyclophosphamide therapy in two cases. Rheumatol Int 2006; 26:454. 103. Fabbian F, Catalano C, Lambertini D, et al. A possible role of corticosteroids in cholesterol crystal embolization. Nephron 1999; 83:189. 104. Elinav E, Chajek-Shaul T, Stern M. Improvement in cholesterol emboli syndrome after iloprost therapy. BMJ 2002; 324:268. 105. Minatohara K. Renal failure associated with blue toe syndrome: effective treatment with intravenous prostaglandin E-1. Acta Derm Venereol 2006; 86:364. 106. Hasegawa M, Sugiyama S. Apheresis in the treatment of cholesterol embolic disease. Ther Apher Dial 2003; 7:435. 107. Tamura K, Umemura M, Yano H, et al. Acute renal failure due to cholesterol crystal embolism treated with LDL apheresis followed by corticosteroid and candesartan. Clin Exp Nephrol 2003; 7:67. 108. Muso E, Mune M, Fujii Y, et al. Significantly rapid relief from steroid-resistant nephrotic syndrome by LDL apheresis compared with steroid monotherapy. Nephron 2001; 89:408. 109. Kronzon I, Tunick PA. Aortic atherosclerotic disease and stroke. Circulation 2006; 114:63. 110. Fujimoto S, Yasaka M, Otsubo R, et al. Aortic arch atherosclerotic lesions and the recurrence of ischemic stroke. Stroke 2004; 35:1426. 111. Kawahara T, Nishikawa M, Kawahara C, et al. Atorvastatin, etidronate, or both in patients at high risk for atherosclerotic aortic plaques: a randomized, controlled trial. Circulation 2013; 127:2327. 112. Igarashi Y, Akimoto T, Kobayashi T, et al. Performing Anticoagulation: A Puzzling Case of Cholesterol Embolization Syndrome. Clin Med Insights Case Rep 2017; https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 27/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate 10:1179547616684649. 113. Lansberg MG, O'Donnell MJ, Khatri P, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141:e601S. 114. http://packageinserts.bms.com/pi/pi_coumadin.pdf (Accessed on October 20, 2010). 115. Keen RR, McCarthy WJ, Shireman PK, et al. Surgical management of atheroembolization. J Vasc Surg 1995; 21:773. 116. Renshaw A, McCowen T, Waltke EA, et al. Angioplasty with stenting is effective in treating blue toe syndrome. Vasc Endovascular Surg 2002; 36:155. 117. Kumins NH, Owens EL, Oglevie SB, et al. Early experience using the Wallgraft in the management of distal microembolism from common iliac artery patholology. Ann Vasc Surg 2002; 16:181. 118. Matchett WJ, McFarland DR, Eidt JF, Moursi MM. Blue toe syndrome: treatment with intra- arterial stents and review of therapies. J Vasc Interv Radiol 2000; 11:585. 119. Ridker PM, Cannon CP, Morrow D, et al. C-reactive protein levels and outcomes after statin therapy. N Engl J Med 2005; 352:20. Topic 8184 Version 24.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 28/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate GRAPHICS Autopsy specimen of atherosclerosis Autopsy specimen from a patient with cholesterol crystal embolism demonstrates severe atherosclerosis of the aorta. Courtesy of Dr. Amy Rapkiewicz. Graphic 54250 Version 1.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 29/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Complex atherosclerotic plaque in the thoracic aorta Complex atherosclerotic plaque in the thoracic aorta visualized by 2D TEE. (A) Ulcerated plaque in the aortic arch. (B) Plaque with a mobile component representing superimposed thrombus (arrow) in the descending thoracic aorta. Courtesy of Dr. Muhamed Saric. Graphic 63285 Version 4.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 30/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Emboli in transit Transesophageal echocardiogram of the descending thoracic aorta in a patient who later died from cholesterol crystal embolization syndrome, with intestinal infarction and renal failure. Note the massive atherosclerotic plaque. The pictures on the right (1A, 2A, 3A) were taken one or two seconds after their respective pictures on the left. The arrows point to small particles of embolic material moving in transit in the aortic lumen. Reproduced with permission from: Freedberg, RS, Tunick, PA, Kronzon, I. Emboli in Transit: The Missing Link. J Am Soc Echocardiogr 1998, 11:826. Copyright 1998 Elsevier. Graphic 64740 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 31/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Livedo reticularis Patient with lupus and anti-phospholipid antibodies with livedo reticularis (manifested by a reddish-cyanotic, reticular pattern of the skin) which has resulted in ulcer formation (arrows). Courtesy of Samuel Moschella, MD. Graphic 71860 Version 1.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 32/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Blue toe syndrome Blue toes are a classic manifestation of peripheral embolization of atheromatous material from proximal arterial sources (eg, aorta); the pedal pulses are often normal. This patient, who has a 30-year history of type 1 diabetes and severe peripheral vascular disease, presented with foot pain and discoloration. Cholesterol microemboli from the aorta were suspected to be the cause. Reproduced with permission from Lawrence B Stack, MD. Copyright Lawrence B Stack, MD. Graphic 58761 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 33/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Cholesterol emboli Acral retiform purpura involving the left foot. Reproduced with permission from: www.visualdx.com. Copyright VisualDx. All rights reserved. Graphic 123032 Version 1.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 34/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Retiform purpura due to cholesterol emboli Retiform purpura (purpura in a pattern reminiscent of livedo reticularis) are present on the buttocks. Reproduced with permission from: www.visualdx.com. Copyright VisualDx. All rights reserved. Graphic 69150 Version 6.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 35/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Cholesterol emboli to the kidney on CT scan A axial CT scan through the kidneys (A) shows punctate perfusion defects in the renal parenchyma (arrows) and regions of diffuse thinning of the cortex (arrowheads). Image B is a magnified view showing tiny perfusion defects (arrows), as well as larger regions of parenchymal thinning (arrowheads). CT: computed tomography. Graphic 98920 Version 1.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 36/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Renal atheroembolus histology Light micrograph of an atheroembolus in a muscular renal artery showing cleft-like spaces (arrow) due to washout of the cholesterol crystals during histologic processing. Courtesy of Helmut Rennke, MD. Graphic 56672 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 37/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Renal atheroembolus toluidine blue Thin section, toluidine blue stain shows the characteristic cholesterol clefts of an atheroembolus in the small renal artery. Courtesy of Helmut Rennke, MD. Graphic 68445 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 38/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Hollenhorst plaque retinal artery Reproduced with permission from: Digital Reference of Opthalmology, Edward S. Harkness Eye Institute, Columbia University, NY. Graphic 63740 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 39/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Thoracic aortic plaque Three transesophageal echocardiograms of the thoracic aorta: left: normal; middle: moderate (3 mm) plaque; and right: severe (7 mm) plaque. Reproduced with permission from: Tunick, PA, Kronzon, I. Atheroembolism. In: Vascular Medicine. A Companion to Braunwald's Heart Disease, 1st edition, Dzau, VJ, Creager, M, Loscalzo, J, et al (Eds), WB Saunders 2005. Copyright 2005 Elsevier. Graphic 72777 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 40/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Atherosclerotic plaque visualized by 3D TEE (A) Protruding plaque in the aortic arch. (B) Ulcerated plaque in the descending thoracica aorta. Courtesy of Dr. Muhamed Saric. Graphic 56112 Version 1.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 41/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Severe aortic plaque Severe aortic plaque (arrow) visualized by gastrointestinal endoscopic ultrasound (EUS) probe. Courtesy of Dr. Zamir Brelvi, Division of Gastroenterology, New Jersey Medical School, Newark, NJ. Graphic 63026 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 42/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Atherosclerotic plaque on CT Atherosclerotic plaque of the descending thoracic and abdominal aorta on CT. Severe atherosclerotic plaque (arrows) visualized by CT in axial (panel A) and sagittal (panel B) projections. CT: computed tomography. Courtesy of Dr. Pierre Maldjian. Graphic 75835 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 43/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Aortic atherosclerosis on MRI Aortic atherosclerosis (arrow) visualized by MRI (T2 weighted images with fat suppression). MRI: magnetic resonance imaging. Courtesy of Dr. Pierre Maldjian. Graphic 55892 Version 2.0 https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 44/45 7/5/23, 11:47 AM Embolism from atherosclerotic plaque: Atheroembolism (cholesterol crystal embolism) - UpToDate Contributor Disclosures Muhamed Saric, MD, PhD, FACC, FASE Consultant/Advisory Boards: Siemens [Two- and three-dimensional echo imaging]. Speaker's Bureau: Abbott [Structural heart disease]; Boston Scientific [Structural heart disease]; Medtronic [Structural heart disease]; Philips [Two- and three-dimensional echo imaging]. All of the relevant financial relationships listed have been mitigated. Catherine M Otto, MD No relevant financial relationship(s) with ineligible companies to disclose. Jos Biller, MD, FACP, FAAN, FAHA No relevant financial relationship(s) with ineligible companies to disclose. John F Eidt, MD Grant/Research/Clinical Trial Support: Syntactx [Clinical events, data/safety monitoring for medical device trials]. All of the relevant financial relationships listed have been mitigated. Joseph L Mills, Sr, MD No relevant financial relationship(s) with ineligible companies to disclose. Kathryn A Collins, MD, PhD, FACS No relevant financial relationship(s) with ineligible companies to disclose. Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence. Conflict of interest policy https://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism/print 45/45