A 72-year-old man arrives at the emergency department complaining of severe abdominal pain and nausea. He has a history of coronary artery disease and had cardiac angiography recently. The patient is an active smoker with a 30-pack-year smoking history. He has an emergency laparotomy after an initial evaluation. A section of the small intestine is removed. As seen in the image below, there are several large-caliber vessels with needle-shaped cholesterol clefts in their lumens. Given these findings, the patient is at highest risk for which of the following complications?

Question

A 72-year-old man arrives at the emergency department complaining of severe abdominal pain and nausea. He has a history of coronary artery disease and had cardiac angiography recently. The patient is an active smoker with a 30-pack-year smoking history. He has an emergency laparotomy after an initial evaluation. A section of the small intestine is removed. As seen in the image below, there are several large-caliber vessels with needle-shaped cholesterol clefts in their lumens.  Given these findings, the patient is at highest risk for which of the following complications?

Quizplus · Accepted Answer

Eductional Objective: Atheroembolic disease is typically caused by mechanical dislodgement of atherosclerotic plaque, resulting in the showering of cholesterol-rich microemboli into the circulation after an invasive vascular procedure. Needle-shaped cholesterol clefts in affected vessels are indicative of the disease. The kidneys (eg, acute kidney injury), skin (eg, blue toe syndrome, livedo reticularis), gastrointestinal tract (eg, bleeding, infarction), and CNS are all commonly involved organs (eg, stroke, amaurosis fugax).

A 72-Year-Old Man Arrives at the Emergency Department Complaining of Severe