Cardiac catheterization is a procedure that helps doctors diagnose conditions of your heart muscles, valves, and arteries.

Cardiac catheterization involves inserting a thin tube into a large blood vessel that leads to your heart to diagnose conditions, such as:

The procedure is considered relatively safe, but like all surgical procedures, it comes with a risk of complications, such as:

Research reports that cholesterol embolism is a complication of intravascular procedures like cardiac catheterization in 0.6–0.9% of people. A cholesterol embolism is a crystal made up of cholesterol and other substances that breaks off a blood vessel. It can lead to organ damage when it gets lodged in small blood vessels.

Read on to learn more about the connection between cholesterol emboli and cardiac catheterization.

A cholesterol embolism is when a cholesterol crystal called an emboli breaks off from plaque inside a blood vessel and gets stuck in a smaller blood vessel. Plaque is the buildup of fatty substances inside your arteries.

About 80% of cholesterol emboli occur after intraarterial surgeries where a small tube or catheter is inserted in one of your major blood vessels, such as cardiac catheterization. Other intraarterial procedures that may lead to an embolism include:

Most emboli break off the aorta or its major branches. Your aorta is the major blood vessel leading away from your heart.

Cholesterol emboli are more common in people ages 60 and older who have atherosclerotic heart disease.

In a study in 2019, researchers followed 1,786 participants undergoing cardiac catheterization. About 1.4% of people developed cholesterol embolism, and 64% of those people developed kidney damage. A definitive cholesterol embolism diagnosis was established in only 0.8% of people.

Risk factors

The top risk factor for cholesterol embolism is atherosclerosis. Atherosclerosis is the buildup of a fatty substance called plaque inside your arteries. It’s estimated that half of people between ages 45 and 84 have atherosclerosis but do not know they have it.

Other risk factors include:

Symptoms of an embolism can vary depending on where the emboli get stuck. The three most common areas affected are:

  • kidneys (31.5%)
  • skin (15.5%)
  • gastrointestinal tract (13.4%)

General symptoms can include:

Specific symptoms of an embolism that may develop include:

A cholesterol embolism can be life threatening. The most common life threatening complication is end-stage kidney failure. In autopsy studies — those done after death — researchers have reported kidney involvement in up to 74% of cholesterol embolism cases.

Other serious complications can include:

People who develop cholesterol embolism often have advanced cardiovascular disease and are in poor overall health. Research has reported death rates as high as 63% to 81%.

In a small study, a group of researchers found an in-hospital death rate of 16% in people who had left-heart catheterization and developed cholesterol embolism. The in-hospital death rate was 0.5% in people who did not develop cholesterol embolisms.

Cholesterol embolisms often cause general symptoms that are hard to tell apart from other conditions. The majority of cases develop after vascular procedures like coronary catheterization. Symptoms often occur within hours to days of the procedure.

It’s important to visit your doctor as soon as possible if you develop any symptoms of an embolism after your procedure, such as abdominal pain or discoloration of your fingers or toes.

Most embolisms develop in men over age 60 with a history of atherosclerosis, so it’s particularly important to visit your doctor if you fall into this demographic.

Medical emergency

A cholesterol embolism can be life threatening. It’s critical to call emergency medical services or go to the nearest emergency room if you or somebody you’re with develops concerning or rapidly progressing symptoms. These might include, but are not limited to:

  • chest pain
  • loss of consciousness
  • confusion
  • shortness of breath
  • seizures

Treatment for a cholesterol embolism is usually supportive since no particular treatment has been developed.

You may be given medications to restore blood flow. Medications your doctor may prescribe to you include:

Further cardiovascular procedures should be avoided if possible to minimize the risk of future embolism.

You may receive surgery to remove the blockage if your doctor can precisely locate the emboli and you’re in good overall health. However, the exact location of the embolism often cannot be located.

Lifestyle changes can reduce your risk of future embolisms. Some changes might include:

Some of these changes can be challenging, especially quitting smoking or losing weight. Reach out to a doctor to help create a sustainable plan that works for you.

A cholesterol embolism is a potential complication of cardiac catheterization and other procedures where a small tube or catheter is inserted into one of your arteries. It most often develops in men over age 60 with atherosclerosis, a buildup of plaque in their blood vessels.

Cholesterol embolisms can be life threatening. It’s important to get medical attention if you develop any symptoms in the days after your procedure.

Your doctor may give you medications to help remove the blockage and other supportive treatments.