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January 27, 1997

Atheroembolism or Cholesterol Crystal Embolization-Reply

Author Affiliations

Leiden, the Netherlands

Arch Intern Med. 1997;157(2):245. doi:10.1001/archinte.1997.00440230124022

Stehbens correctly notes that an active search of all body tissues in large numbers of patients and controls is the only way to gain knowledge on the true incidence, prevalence, and outcome of cholesterol crystal embolization (CCE). To date, the estimates come from series of more or less selected cases and therefore vary widely.1-6 In a study of 34 consecutive autopsies on subjects aged 60 years or older, Gore and Collins2 found 6 cases of CCE. In an attempt to find out how common CCE really is, Cross4 examined histological sections of spleen and both kidneys from 372 consecutive autopsies: it was identified in 9. The subjects were mostly men in their 60s or 70s with a history of atherosclerotic disease. Estimates of the mortality rate of CCE range from 0% to 81%, also owing to the different selection criteria of the studies. Our study was limited

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