Intestinal cholesterol embolism resulting from intra-aortic balloon pumping: a case report

INTRODUCTION: Intra-aortic balloon pumping is used in elective percutaneous coronary intervention for increasing coronary blood flow. However, intra-aortic balloon pumping may decrease visceral blood flow and cause mesenteric ischemia by visceral artery obstruction. CASE PRESENTATION: We report the case of a 79-year-old Asian man in whom elective percutaneous coronary intervention was performed with intra-aortic balloon pumping. He died from mesenteric ischemia 25 hours after the procedure. Microscopic findings showed that intra-aortic balloon pumping had detached the aortic plaque, breaking it into systemic emboli, leading to subsequent intestinal ischemia and necrosis. CONCLUSIONS: We conclude that intra-aortic balloon pumping can cause an intestinal cholesterol embolism.