ABSTRACT
Severe atherosclerosis of the aorta and its branches may result in spontaneous or iatrogenic embolic phenomena ranging from asymptomatic findings on tissue biopsy to organ infarction and fatal multisystem failure. Atherosclerotic disease of the abdominal aorta has long been recognized as an embolic source. Although the manifestations of atheroembolism may be transient and self-limited, they can also progress to permanent organ damage and death. Although patients who have thromboembolism emanating from thoracic aortic plaque may also have cholesterol crystals demonstrated on muscle or skin biopsy, the typical atheroemboli syndrome is quite uncommon in follow-up. Both atheroembolism and thromboembolism originating from the aorta may occur spontaneously. However, both are more likely to occur after instrumentation of the aorta. The diagnosis of the atheroembolism syndrome can be elusive, as patients may present with multisystem findings. They may be thought to have necrotizing vasculitis, meningococcemia or gonococcemia, endocarditis, or other sepsis with disseminated intravascular coagulation.
