Catheter interventional treatment in Kawasaki disease: A report from the Japanese Pediatric Interventional Cardiology Investigation Group

Akagi, Teiji; Ogawa, Satoshi; Ino, Toshihiro; Iwasa, Mitsuji; Echigo, Shigeyuki; Kishida, Kenji; Baba, Kiyoshi; Matsushima, Masaki; Hamaoka, Kenji; Tomita, Hideshi; Ito, Masahiro; Kato, Hirohisa

doi:10.1067/mpd.2000.107164

Cited by 74 publications

(57 citation statements)

References 15 publications

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“…Previous studies have demonstrated that PBA is effective for patients within 6 years of the onset of KD, but at Ͼ6 years after onset, it is less effective. 5,8,15 In the present study, PBA successfully resolved stenotic lesions in 3 patients for whom the time since onset of KD had been Ͻ4 years. There have been a few reports in which stent implantation, a technique of coronary intervention commonly performed in adult patients, was applied to KD patients.…”

Section: Discussion Comparison With Previous Studiesmentioning

confidence: 88%

“…Our proposed criteria for device selection are summarized here on the basis of the results from present and previous studies. [5][6][7][8][9][15][16][17] It is well known that PBA alone is less effective for long-term lesions with severe calcification. [5][6][7][8][9] Half of all coronary artery stenotic lesions, however, occur within 2 years of KD onset.…”

Section: Selection Of An Appropriate Device For Catheter Interventionmentioning

confidence: 99%

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Sequential Follow-Up Results of Catheter Intervention for Coronary Artery Lesions After Kawasaki Disease

et al. 2002

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Background-The purpose of this study was to assess the sequential follow-up results of catheter intervention in Kawasaki disease by use of quantitative coronary angiography (QCA) and intravascular ultrasound imaging. Methods and Results-Catheter intervention was performed on 23 stenotic lesions in 22 patients (aged 2 to 24 years).Percutaneous balloon angioplasty (PBA) was performed in 4 patients, stent implantation in 7, percutaneous transluminal coronary rotational ablation (PTCRA) in 10, and a combination of PTCRA with stent implantation in 2. A total of 21 lesions (91%) were successfully dilated by catheter intervention without major or minor complications. One patient immediately underwent coronary artery bypass grafting (CABG) surgery because stent implantation failed to resolve his lesion. At 4 to 6 months after catheter intervention, 2 restenotic lesions (9%) were detected by QCA in 2 patients who had undergone PBA, and these patients subsequently underwent CABG surgery. In 6 months to 3 years after catheter intervention, no patients showed evidence of ischemic findings. At 3 to 4 years after catheter intervention, QCA and intravascular ultrasound studies were performed on 15 lesions in 14 patients. Two restenotic lesions (13%) were detected by QCA in 2 patients. One of the 2 had stent implantation and underwent CABG surgery, and the other had undergone PTCRA and underwent re-PTCRA. Thirteen patients demonstrated no ischemic findings at 3 to 8 years after catheter intervention. Conclusion-Catheter intervention for Kawasaki disease can be accomplished and can be effective in the short term, but the long-term efficacy should be verified by further study. (Circulation. 2002;105:3004-3010.)

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Section: Discussion Comparison With Previous Studiesmentioning

confidence: 88%

Section: Selection Of An Appropriate Device For Catheter Interventionmentioning

confidence: 99%

Sequential Follow-Up Results of Catheter Intervention for Coronary Artery Lesions After Kawasaki Disease

et al. 2002

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“…3 However, the incidence of coronary revascularization was not investigated. A national survey of catheter interventions after kDa was reported in 2000, 4 whereas a previous multicenter cooperative study for coronary artery bypass grafting (CABG) after kDa in Japan was performed in 1991. 5 After that survey, it was unknown how many patients underwent CABG for coronary arterial lesions caused by kDa.…”

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confidence: 99%

National Survey of Coronary Artery Bypass Grafting for Coronary Stenosis Caused by Kawasaki Disease in Japan

Tsuda

Kitamura²

2004

Circulation

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Background-We surveyed the national experience of coronary artery bypass grafting (CABG) for coronary sequelae of Kawasaki disease (kDa) in 2002. Methods and Results-A questionnaire was returned from 323/552 (59%) institutions. Two hundred forty-four patients (188 male 56 female) since 1975 were identified. The mean number of grafts was 1.8 and the age at operation ranged from 1 to 44 years (median 11 years). The interval from the onset of kDa to operation ranged from 1 month to 42 years (median 8 years), whereas the follow-up period was from 7 days to 25 years (median 5 years). Previous myocardial infarction was found in 70 patients (28%). When the age at operation was older than 12 years, patency rates for internal thoracic artery grafts (ITA) at 1, 5, and 15 years were 95%, 91%, and 91%, respectively (nϭ156). When the age at operation was younger than 12 years, the corresponding values were significantly lower, with 1, 5, and 15 years being 93%, 73%, and 65%, respectively (nϭ146) (PϽ0.05). Reoperation was performed in 14 patients (6%

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“…[4][5][6] In contrast, drug-coated balloons (DCB) now play a central role in the treatment of in-stent restenosis through their inhibition of neointimal hyperplasia, despite the lack of evidence for de novo coronary artery disease. 7,8) We describe here our experience with an atherosclerotic-restenosis case of probable coronary sequelae of KD previously treated with rotational atherectomy with additional low-pressure balloon dilation 6 months before, 3) in which rotational atherectomy followed by DCB dilation could defer any subsequent repeat intervention.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Since these stiff calcified lesions have risk of stent underexpansion and neo-aneurysmal formation ascribed to high-pressure balloon inflation, rotational atherectomy with/without additional low-pressure balloon dilation alone has been a mainstay of interventional treatment for stenosis due to the coronary sequelae of KD. [4][5][6] In contrast, drug-coated balloons (DCB) now play a central role in the treatment of in-stent restenosis through their inhibition of neointimal hyperplasia, despite the lack of evidence for de novo coronary artery disease. 7,8) We describe here our experience with an atherosclerotic-restenosis case of probable coronary sequelae of KD previously treated with rotational atherectomy with additional low-pressure balloon dilation 6 months before, 3) in which rotational atherectomy followed by DCB dilation could defer any subsequent repeat intervention.…”

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confidence: 99%

Rotational Atherectomy Followed by Drug-Coated Balloon Dilation in Possible Coronary Sequelae of Kawasaki Disease

et al. 2016

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SummaryRotational atherectomy with/without low-pressure balloon dilation has been a mainstay of interventional treatment for stenosis due to the coronary sequelae of Kawasaki disease (KD). Here, we report a restenosis case of probable coronary sequelae of KD treated with rotational atherectomy with low-pressure 2.5-mm balloon dilation 6 months previously. Under the guidance of optical frequency domain imaging, we performed rotational atherectomy followed by 2.5-mm drug-coated balloon (DCB) dilation for an atherosclerotic restenosis at the inlet of a calcified aneurysm in the proximal left anterior descending coronary artery. Coronary angiography 6 months later showed no apparent progression of vessel narrowing, and we could defer repeat intervention. The present case suggests that rotational atherectomy followed by DCB dilation could be an alternative revascularization therapy of choice in coronary KD sequelae complicated with atherosclerosis. (Int Heart J 2016; 57: 367-371) Key words: Optical frequency domain imaging, Fractional flow reserve, Atherosclerosis, Dyslipidemia C oronary sequelae of Kawasaki disease (KD) has a variety of morphological manifestations, such as aneurysm, stenosis, and total occlusion concomitant with nonatherosclerotic intimal thickening and frequent severe calcification, while a few reports have demonstrated early atherosclerosis progression in young adults with prior KD.1-3) Since these stiff calcified lesions have risk of stent underexpansion and neo-aneurysmal formation ascribed to high-pressure balloon inflation, rotational atherectomy with/without additional low-pressure balloon dilation alone has been a mainstay of interventional treatment for stenosis due to the coronary sequelae of KD. [4][5][6] In contrast, drug-coated balloons (DCB) now play a central role in the treatment of in-stent restenosis through their inhibition of neointimal hyperplasia, despite the lack of evidence for de novo coronary artery disease. 7,8) We describe here our experience with an atherosclerotic-restenosis case of probable coronary sequelae of KD previously treated with rotational atherectomy with additional low-pressure balloon dilation 6 months before, 3) in which rotational atherectomy followed by DCB dilation could defer any subsequent repeat intervention. Case ReportAn asymptomatic 47 year-old male was admitted to our hospital to undergo 6-month follow-up coronary angiography (CAG). Six months previously, based on a diagnosis of silent myocardial ischemia due to possible sequelae of KD, we had performed rotational atherectomy with 1.5/2.0 mm burrs followed by low-pressure dilation using a balloon catheter 2.5/15 mm at 4 atm for a stenosis at the inlet of a calcified aneurysm in the proximal segment of the left anterior descending coronary artery (LAD) ( Figure 1A, 1B). Although he had no apparent history of KD, he was hospitalized for 40 days due to fever of unknown cause with systemic eruption at the age of 6 months. His coronary risk factor was dyslipidemia, and under medication consisting ...

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Catheter interventional treatment in Kawasaki disease: A report from the Japanese Pediatric Interventional Cardiology Investigation Group

Cited by 74 publications

References 15 publications

Sequential Follow-Up Results of Catheter Intervention for Coronary Artery Lesions After Kawasaki Disease

Sequential Follow-Up Results of Catheter Intervention for Coronary Artery Lesions After Kawasaki Disease

National Survey of Coronary Artery Bypass Grafting for Coronary Stenosis Caused by Kawasaki Disease in Japan

Rotational Atherectomy Followed by Drug-Coated Balloon Dilation in Possible Coronary Sequelae of Kawasaki Disease

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