title: Interventional treatment for children with severe coronary artery stenosis with calcification after long-term Kawasaki disease.
abstract: BACKGROUND
  About 4% of children with Kawasaki disease (KD) eventually develop ischemic heart disease, which is often associated with calcified stenosis. We assessed the utility of the percutaneous transluminal coronary rotational ablation (PTCRA) in children with coronary artery stenosis after KD.
  
  
  RESULTS
  Four children (three boys and one girl; age, 12 to 13 years) with coronary artery stenosis underwent percutaneous transluminal coronary angioplasty (PTCA) and PTCRA 11.8+/-0.9 years after the onset of KD. Morphology of the coronary artery wall was evaluated by intravascular ultrasound imaging. In one patient, the targeted lesion for intervention was in the left anterior descending artery (90% stenosis); in the other three patients, it was in the middle of the right coronary artery (75% to 90% stenosis). PTCA failed in three patients because of severe stenosis with calcification. However, PTCRA proved effective, with stenosis rates reduced from 90% to 25%. Follow-up coronary angiography performed 4 months after the procedure demonstrated no restenosis, but mild aneurysms occurred in two patients.
  
  
  CONCLUSIONS
  This study suggests that PTCRA is useful for revascularizing coronary arteries with severe stenosis and calcification as long-term sequelae of KD. Intravascular ultrasound imaging is useful in assessing the coronary artery wall pathology and in selecting the best treatment intervention.
authors.affiliation: Department of Pediatrics, Kurume University School of Medicine, Kokura Memorial Hospital, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sugimura
authors.forename: H
authors.initials: H
authors.lastname: Yokoi
authors.forename: N
authors.initials: N
authors.lastname: Sato
authors.forename: T
authors.initials: T
authors.lastname: Akagi
authors.forename: T
authors.initials: T
authors.lastname: Kimura
authors.forename: M
authors.initials: M
authors.lastname: Iemura
authors.forename: M
authors.initials: M
authors.lastname: Nobuyoshi
authors.forename: H
authors.initials: H
authors.lastname: Kato
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D002114:Calcinosis; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009206:Myocardium / Q000473:pathology*; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional