Cholesterol embolization syndrome after carotid artery stenting associated with delayed cerebral hyperperfusion intracerebral hemorrhage

Background: The cholesterol embolization syndrome (CES) results from the distal embolization of cholesterol crystals from atheromatous plaques in large vessels such as the aorta and results in multi-organ damage.background CASE DESCRIPTION: We present a case of definite CES with skin manifestation (blue toes), renal and neurological dysfunction (parenchymal hematoma with cytotoxic and vasogenic edema) after having undergone left carotid artery stenting for symptomatic critical left carotid artery stenosis.

Conclusions: Our case of CES had cutaneous involvement affecting the lower limbs, kidneys renal and included neurological involvement. High clinical suspicion and early treatment can reduce mortality and morbidity after endovascular procedures.conclusion The neurological symptoms were most likely a result of delayed cerebral hyperperfusion syndrome resulting in intracerebral haemorrhage.

Keywords: CES; Cholesterol embolization syndrome; carotid artery stenting; hyperperfusion hemorrhage.