Catheter interventional treatment in Kawasaki disease: a report from the Japanese Pediatric Interventional Cardiology Investigation Group

Citation
T. Akagi et al., Catheter interventional treatment in Kawasaki disease: a report from the Japanese Pediatric Interventional Cardiology Investigation Group, J PEDIAT, 137(2), 2000, pp. 181-186
Citations number
20
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics,"Medical Research General Topics
Journal title
JOURNAL OF PEDIATRICS
ISSN journal
0022-3476 → ACNP
Volume
137
Issue
2
Year of publication
2000
Pages
181 - 186
Database
ISI
SICI code
0022-3476(200008)137:2<181:CITIKD>2.0.ZU;2-B
Abstract
Objective: To assess the current status of catheter intervention in Kawasak i disease and to evaluate its efficacy and outcome. Study design: 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 per cutaneous transluminal coronary angioplasty (PTCA; n = 34), percutaneous tr ansluminal coronary rotational ablation (PTCRA; n = 13), directional corona ry 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 st ents. 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 t he use of high-pressure balloon inflation. Two deaths were reported as acut e complications. Conclusions: Catheter intervention is a promising therapeutic strategy in t he 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.