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A 72-year-old man presented with unstable angina. An urgent cardiac catheterization showed clinically significant disease in the right coronary artery, which was stented. Twelve hours after the procedure, livedo reticularis developed on his legs and there was a bluish discoloration of his toes (Panels A and B). The evaluation was notable for an increase in his serum creatinine level from 1.5 mg per deciliter (135 µmol per liter) to 3.1 mg per deciliter (276 µmol per liter), eosinophilia of 7.4 percent, and a normal result on renal ultrasonography. A diagnosis of cholesterol emboli was made. The patient recovered uneventfully.
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