Catheter interventional treatment in Kawasaki disease: A report from the Japanese Pediatric Interventional Cardiology Investigation group.
OBJECTIVE
To assess the current status of catheter intervention in Kawasaki disease and to evaluate its efficacy and outcome.


METHODS
A questionnaire was sent to 55 major institutions in Japan.


RESULTS
A total of 58 procedures in 57 patients were reported. The median age at the time of intervention was 12.1 years. The procedures included percutaneous transluminal coronary angioplasty (PTCA; n = 34), percutaneous transluminal coronary rotational ablation (PTCRA; n = 13), directional coronary atherectomy (DCA; n = 4), and stent implantation (n = 7). The immediate success rate was 74% for PTCA, 100% for PTCRA, 100% for DCA, and 86% for stents. The interval from the onset of disease to intervention in successful PTCA (n = 25) was significantly shorter than that in unsuccessful PTCA (n = 9). Restenosis after PTCA was observed in 24%. Development of new coronary aneurysms was reported in 3 patients for PTCA, 2 for PTCRA, 3 for DCA, and 1 for stents. Except for the DCA, all new aneurysms were associated with the use of high-pressure balloon inflation. Two deaths were reported as acute complications.


CONCLUSIONS
Catheter intervention is a promising therapeutic strategy in the management of coronary stenosis caused by Kawasaki disease. Care should be paid to avoid acute coronary arterial complications and the development of new coronary aneurysms.
Akagi
T
T
Department of Pediatrics, Kurume University School of Medicine, Kurume, Japan.
Ogawa
S
S
Ino
T
T
Iwasa
M
M
Echigo
S
S
Kishida
K
K
Baba
K
K
Matsushima
M
M
Hamaoka
K
K
Tomita
H
H
Ishii
M
M
Kato
H
H
D000293:Adolescent; D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome