Cholesterol embolism, also known as atheroembolism or cholesterol embolization syndrome, is when a crystal of cholesterol breaks off a plaque deposit inside one of your arteries. This cholesterol crystal can then travel through your bloodstream and block blood flow in one of your smaller blood vessels.

Symptoms of a cholesterol embolism vary based on which blood vessel is blocked. Severe symptoms or even death can occur if one of your major organs is affected.

In this article, we’ll examine cholesterol embolism, including causes, symptoms, and treatment options.

When plaque builds up inside your arteries, it raises your risk of developing cardiovascular diseases such as heart attack, stroke, or cholesterol embolism.

A cholesterol embolism occurs when crystals made up of cholesterol and other molecules — such as platelets and proteins — dislodge from the lining of one of your large arteries. This can often happen in the aorta, which is the largest artery in the body and carries blood away from your heart.

When the crystals travel through your bloodstream and reach smaller blood vessels, they can block blood flow and cause inflammation.

This blockage and inflammation can damage the organs or tissues that are supplied by that blood vessel. The most commonly affected organs are your:

  • kidneys
  • skin
  • gastrointestinal system
  • brain

A cholesterol embolism frequently causes general symptoms such as:

Along with these general symptoms, people with a cholesterol embolism can develop symptoms specific to the affected organ. Symptoms often get worse over time as the blockage gets worse.

The most commonly affected areas are:

  • Kidney: 31.5 percent
  • Skin: 15.5 percent
  • Gastrointestinal tract: 13.4 percent

Symptoms can include:

A long time can pass between developing a cholesterol embolism and noticing symptoms. For instance, skin symptoms may not appear for more than a month.

Doctors often diagnosis cholesterol embolism by examining your medical history and symptoms. Most people who develop a cholesterol embolism have a buildup of plaque in their blood vessels. Some may have recently had a cardiovascular procedure.

If the doctor needs more information to make their diagnosis, they may order additional tests.

The gold standard test is a tissue biopsy at the affected area. During a biopsy, the doctor extracts a small amount of tissue to be analyzed in a lab. Depending on where the embolism is located, the biopsy may be taken from your:

  • skin
  • muscle tissue
  • kidney
  • stomach
  • colon
  • bone marrow

The doctor may order other tests, such as a urine test or complete metabolic panel, to rule out other conditions that can cause similar symptoms.

They may also check inflammatory markers, which are commonly elevated in cholesterol-embolism syndrome. These may include:

  • lactate
  • C-reactive protein
  • erythrocyte sedimentation rate
  • lactate dehydrogenase

Complete blood counts may also reveal anemia, leukocytosis, and thrombocytopenia.

People with atherosclerosis are at the highest risk of developing cholesterol embolism. Atherosclerosis is a narrowing of your arteries due to a build-up of plaque.

The severity of your atherosclerosis is directly related to your chances of developing a cholesterol embolism.

In about 80 percent of cases, cholesterol embolism occurs after an endovascular procedure. An endovascular procedure is when something is inserted into one of your blood vessels. Examples include:

Other risk factors for developing a cholesterol embolism include:

There is no one specific treatment for cholesterol embolism. Treatment includes managing symptoms, lowering cholesterol levels, and preventing future cardiovascular disease.

If you’ve had a cholesterol embolism, you may be encouraged to adopt lifestyle habits that lower your risk of a future cardiovascular event. Healthy habits include:

Next, we’ll go over additional therapies that your doctor may suggest.

Medications

Some studies have found that statins may help improve outcomes for people with skin or kidney symptoms. These medications reduce inflammation, lower low-density lipoprotein (LDL) cholesterol levels, and help stabilize plaque in your arteries.

Anti-inflammatory medications may be prescribed to reduce inflammation caused by the embolism. Some case studies have shown benefits from corticosteroids or cyclophosphamide, but more research is needed to understand how these drugs should best be used.

Other medications that may be used to treat a cholesterol embolism include:

Renal replacement therapy

Nearly 50 percent of people with cholesterol embolism need renal replacement therapy. Renal replacement therapy is a way to filter your blood when your kidneys aren’t working properly.

Renal replacement therapies include:

Surgery and interventions

Surgeries such as a bypass procedure or surgical removal of a blockage (endarterectomy) may be used in certain cases. However, sometimes doctors are unable to find the precise location of the problem.

Angioplasty and stent implantation has been used to treat people with a blockage in the major arteries. This procedure involves inserting a balloon, wire mesh, or both, into an artery to keep it open.

However, surgery comes with a risk of further blockages and other complications. It’s often saved for life-threatening situations.

People who’ve had a cholesterol embolism generally have a poor prognosis. Often, they have advanced atherosclerosis and risk factors for developing other serious cardiovascular diseases.

Your outlook depends on the severity of the underlying disease, number of risk factors you have, and size of your blockage.

Studies have reported a mortality rate as high as 63 to 81 percent, depending on how it’s measured.

People who survive often have serious long-term effects, such as:

  • amputation
  • long-term need for renal replacement therapy
  • bowel removal
  • chronic dialysis

If you have high cholesterol and any worsening symptoms, check with your doctor to prevent an embolism or other serious secondary conditions.