This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Michael W. Schwartz, MD; George B. McDonald, MD
Veterans Administration Medical Center University of Washington School of Medicine Seattle

JAMA. 1988;259(8):1180.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—We acknowledge that the two cases of cholesterol embolization syndrome on which we reported had predisposing risks for this condition independent of streptokinase therapy; indeed, we emphasized this in our report. Nonetheless, we were struck by the occurrence of this syndrome following cardiac catheterization and fibrinolytic therapy in a community in which thousands of catheterizations are performed each year and yet in which fulminant cases of cholesterol embolization are rare. Our concern was heightened by two reports in the literature of cholesterol embolization in patients receiving streptokinase without other clear-cut risks,^1,2 which we also pointed out in our article. Since this syndrome is thought to result from the disruption of protective thrombi overlying ulcerated atherosclerotic plaques, we believe there is a strong likelihood that fibrinolytic therapy contributed to its pathogenesis in our two cases. Our view is that fibrinolytic agents may have an effect that is additive . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?