title: A case of Kawasaki's disease with extensive calcifications needing rotational atherectomy with a 2.5mm burr.
abstract: This case report demonstrates a unique strategy requiring a 2.5 mm burr to treat in-stent restenosis of an originally underexpanded stent, implanted in a heavily calcified lesion within a giant aneurysm by Kawasaki disease. Despite our procedural success, it should be emphasized that stent implantation in undilatable lesions should be avoided. When an angiographically calcified lesion within an ectatic segment is observed in a patient with Kawasaki disease, it is recommended that the operator evaluates in detail the severity and location of calcification using intravascular ultrasound imaging and pays meticulous attention to lesion preparation.
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Kastsumasa
authors.initials: K
authors.lastname: Sato
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Charis
authors.initials: C
authors.lastname: Costopoulos
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Vasileios F
authors.initials: VF
authors.lastname: Panoulas
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Toru
authors.initials: T
authors.lastname: Naganuma
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy. Electronic address: info@emocolumbus.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000328:Adult; D017225:Atherectomy, Coronary / Q000295:instrumentation*; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D023903:Coronary Restenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000175:diagnosis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
keywords: Excimer laser coronary atherectomy; In-stent restenosis; Percutaneous coronary intervention; Rotablator