Interventions in Kawasaki disease.
During the past 10 years, the clinical experience of catheter interventional treatment in Kawasaki disease has gradually increased. These treatments include balloon angioplasty, stent implantation, rotational ablation, and transluminal coronary revascularization. Because coronary artery stenosis in Kawasaki disease commonly involves severe calcification, in contrast with adult atherosclerotic coronary artery lesions, the indication or technique of catheter intervention for adult patients cannot be directly determined. Satisfactory acute results for coronary balloon angioplasty were obtained in patients in a relatively short interval from the onset of disease, especially within 6 years. However, the incidence of restenosis after angioplasty was still high. Rotational ablation may be the most appropriate catheter intervention for Kawasaki disease. The advantage of rotational ablation is the high success rate, even in patients with calcified coronary artery stenosis. Stent implantation requires larger arterial access and is not possible in younger children. Care should be paid to the detection of new aneurysm formation because this was associated with the use of additional balloon angioplasty using high-pressure balloon inflation. Anticoagulation or antiplatelet regimens are essential for long-term management.
Akagi
T
T
Cardiac Care Unit, Okayama University Hospital, 2-5-1, Shikata-cho, Okayama, Japan. t-akagi@cc.okayama-u.ac.jp
D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D017115:Catheter Ablation; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000503:physiopathology / Q000628:therapy*; D015607:Stents