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Three cases of young children who underwent effective catheter treatment for severe coronary stenosis caused by Kawasaki disease

Published:January 17, 2023DOI:https://doi.org/10.1016/j.jccase.2023.01.001

      Abstract

      Three patients, aged 2 years 0 months, 2 years 2 months, and 6 years 1 month at the time of plain old balloon angioplasty (POBA), developed an aneurysm in the left anterior descending coronary branch after suffering from Kawasaki disease. POBA was subsequently performed due to 99 % stenosis proximal to the aneurysm. There was no restenosis within a few years after percutaneous coronary intervention, and there was no evidence of ischemia, although 75 % restenosis occurred in two patients after 7 years.
      Although calcified lesions are more likely to occur 6 years after the onset of Kawasaki disease, none of the patients in this study had calcified lesions within 4 years of Kawasaki disease onset, and good results were obtained with POBA alone. POBA can be safely performed in children and is an effective treatment for improving myocardial ischemia if calcification has not progressed.

      Learning objective

      Plain old balloon angioplasty (POBA) can be performed effectively and safely for Kawasaki disease coronary artery stenosis in early childhood if calcification is minimal, with little restenosis for at least several years. POBA is a useful tool in the treatment of coronary artery stenosis in early childhood.

      Abbreviations:

      KD (Kawasaki disease), PCI (Percutaneous coronary intervention), POBA (Plain old ballon angioplasty), CAL (Coronary artery lesion)

      Keywords

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      References

        • Akagi T.
        Interventions in Kawasaki disease.
        Pediatr Cardiol. 2005; 26: 206-212https://doi.org/10.1007/s00246-004-0964-2
        • Fukazawa R.
        • Kobayashi J.
        • Ayusawa M.
        • Hamada H.
        • Miura M.
        • Mitani Y.
        • Tsuda E.
        • Nakajima H.
        • Matsuura H.
        • Ikeda K.
        • Nishigaki K.
        • Suzuki H.
        • Takahashi K.
        • Suda K.
        • Kamiyama H.
        JCS/JSCS 2020 guideline on diagnosis and management of cardiovascular sequelae in Kawasaki disease.
        Circ J. 2020; 84: 1348-1407https://doi.org/10.1253/circj.CJ-19-1094
        • Ino T.
        • Akimoto K.
        • Ohkubo M.
        • Nishimoto K.
        • Yabuta K.
        • Takaya J.
        • Yamaguchi H.
        Application of percutaneous transluminal coronary angioplasty to coronary arterial stenosis in Kawasaki disease.
        Circulation. 1996; 93: 1709-1715https://doi.org/10.1161/01.cir.93.9.1709
        • Mitani Y.
        • Ohashi H.
        • Sawada H.
        • Ikeyama Y.
        • Hayakawa H.
        • Takabayashi S.
        • Maruyama K.
        • Shimpo H.
        • Komada Y.
        In vivo plaque composition and morphology in coronary artery lesions in adolescents and young adults long after Kawasaki disease: a virtual histology-intravascular ultrasound study.
        Circulation. 2009; 119 (CIRCULATIONAHA.108.818609 (pii)): 2829-2836https://doi.org/10.1161/CIRCULATIONAHA.108.818609
        • Miura M.
        • Kobayashi T.
        • Kaneko T.
        • Ayusawa M.
        • Fukazawa R.
        • Fukushima N.
        • Fuse S.
        • Hamaoka K.
        • Hirono K.
        • Kato T.
        • Mitani Y.
        • Sato S.
        • Shimoyama S.
        • Shiono J.
        • Suda K.
        Association of severity of coronary artery aneurysms in patients with Kawasaki disease and risk of later coronary events.
        JAMA Pediatr. 2018; 172e180030https://doi.org/10.1001/jamapediatrics.2018.0030
        • Hirovoshi Y.
        The role of coronary intervention to coronary artery stenosis in Kawasaki disease. Nihon rinsho.
        Jpn J Clin Med. 2014; 72: 1664-1668
        • Alfonso F.
        • Pérez-Vizcayno M.J.
        • Cardenas A.
        • García del Blanco B.
        • Seidelberger B.
        • Iñiguez A.
        • Gómez-Recio M.
        • Masotti M.
        • Velázquez M.T.
        • Sanchís J.
        • García-Touchard A.
        • Zueco J.
        • Bethencourt A.
        • Melgares R.
        • Cequier A.
        • et al.
        A randomized comparison of drug-eluting balloon versus everolimus-eluting stent in patients with bare-metal stent-in-stent restenosis: the RIBS V clinical Trial(Restenosis intra-stent of bare metal stents: paclitaxel-eluting balloon vs. Everolimus-eluting stent).
        J Am Coll Cardiol. 2014; 63: 1378-1386
        • Kato H.
        • Sugimura T.
        • Akagi T.
        • Sato N.
        • Hashino K.
        • Maeno Y.
        • Kazue T.
        • Eto G.
        • Yamakawa R.
        Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients.
        Circulation. 1996; 94: 1379-1385