Visualizing high‐intensity thrombosis with plaque imaging of coronary aneurysm in Kawasaki disease

2021 ◽  
Vol 63 (11) ◽  
pp. 1405-1407
Author(s):  
Akiyuki Kotoku ◽  
Kentaro Aso ◽  
Takayuki Yamada ◽  
Naoki Shimizu ◽  
Hidefumi Mimura
Keyword(s):  
Kawasaki Disease ◽  
High Intensity ◽  
Coronary Aneurysm ◽  
Plaque Imaging

Variation in the management of Kawasaki disease

2019 ◽  
Vol 105 (10) ◽  
pp. 1004-1006 ◽  
Author(s):  
Audrey Dionne ◽  
David Burgner ◽  
Sarah De Ferranti ◽  
Davinder Singh-Grewal ◽  
Jane Newburger ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Initial Treatment ◽  
Coronary Aneurysm ◽  
Medical Specialty ◽  
Primary Treatment ◽  
Management Options ◽  
Necrosis Factor Alpha ◽  
Coronary Aneurysms ◽  
Factor Alpha ◽  
Collaborative Efforts

Intravenous immunoglobulin (IVIG) reduces coronary aneurysms in patients with Kawasaki disease (KD), but additional management options remain challenging, with no generalisable evidence-based recommendations. We performed a survey of 724 physicians from 73 countries to assess variation in practice. IVIG was the preferred initial treatment by 659 (91%) of respondents. Criteria for adjunctive primary treatment varied considerably and definitions of IVIG resistance varied markedly by geographical continent, Human Development Index tiers and medical specialty. A second dose of IVIG was used most often for patients with coronary aneurysm non-responsive to initial treatment (572, 79%), but corticosteroids (379, 52%) and tumour necrosis factor alpha inhibitors (208, 29%) were also frequently used. Our findings highlight the need for international collaborative efforts to optimise management of patients with KD worldwide.

scholarly journals Predictive value of brachial artery flow-mediated dilation on coronary artery abnormality in acute stage of Kawasaki disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yizhou Wen ◽  
Xianmin Wang ◽  
Yonghong Guo ◽  
Mei Jin ◽  
Jimei Xi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Brachial Artery ◽  
Characteristic Curve ◽  
Coronary Aneurysm ◽  
Acute Stage ◽  
Flow Mediated Dilation ◽  
Strong Negative Correlation ◽  
Coronary Artery Abnormality ◽  
Artery Flow

AbstractCoronary artery abnormalities (CAAs) are a severe complication of Kawasaki disease (KD) that may lead to cardiovascular events. Given the evidence that brachial artery flow-mediated dilation (FMD) decreases in children after the onset of KD, we hypothesized that it could be an early marker of CAA development in the acute stage and investigated its relationship with variation in the coronary artery diameter. A total of 326 sex- and age-matched children were enrolled, including 120 with KD, 109 febrile children and 97 healthy controls. In this study, FMD was significantly decreased in the KD group compared with the febrile and healthy groups. FMD was lower in the CAA group than in the no coronary artery abnormality group. The comparison of FMD showed an obvious difference among the CAA subgroups. The FMD in the coronary aneurysm (CA) group showed a strong negative correlation with the pretreatment maximum coronary artery Z-score (preZmax). While preZmax was 2.5, the receiver operating characteristic curve indicated an optimal cutoff point of 3.44% for FMD. FMD ≤ 3.44% could be considered as a signal of coronary lesions in acute stage of KD.

scholarly journals Effectiveness and Luminal Changes of Rotablator without Adjunctive PTCA for Calcified Stenosis Associated with Coronary Aneurysm of Kawasaki Disease

2003 ◽  
Vol 53 (1) ◽  
pp. 163-163
Author(s):  
Kazuo Misumi ◽  
Yoshito Sakata ◽  
Yuko Kurasaki ◽  
Hiroshi Shibayama ◽  
Hitoshi Ezumi ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Coronary Aneurysm

scholarly journals 1002-91 Plasma Endothelin-1 in Acute Phase of Kawasaki Disease Complicated with Coronary Aneurysm

1995 ◽  
Vol 25 (2) ◽  
pp. 351A
Author(s):  
Mamoru Ayusawa ◽  
Kensuke Karasawa ◽  
Tsunehisa Yamashita ◽  
Nobutaka Noto ◽  
Hideo Yamaguchi ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Acute Phase ◽  
Coronary Aneurysm ◽  
Endothelin 1

Abstract 219: Long - Term Prognosis Of Patients With Kawasaki Disease Complicated By Significant Coronary Aneurysm (diameter ≥ 6 mm)

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Ji Seok Bang ◽  
Gi Beom Kim ◽  
Bo Sang Kwon ◽  
Eun Jung Bae ◽  
Chung Il Noh ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Aneurysm ◽  
Coronary Intervention ◽  
Surgical Interventions ◽  
Coronary Aneurysms ◽  
The Mean

Background: Some patients with Kawasaki disease (KD) develop large coronary aneurysms (diameter ≥ 6mm) and coronary stenosis, leading to ischemic heart disease. This study determined the long-term outcome for patients with Kawasaki disease complicated by significant coronary aneurysm. Methods and Results: From the database in Seoul National University Children’s Hospital between December 1986 and December 2013, medical records of 83 patients (61 men and 22 women) with large coronary aneurysms (diameter ≥ 6mm) were retrospectively reviewed. Information on patient demographics, catheter or surgical interventions, and most recent status was collected. From these data, we calculated the survival rate, cumulative coronary intervention rate, coronary artery bypass graft surgery rate. The mean age at onset was 4.28 ± 2.62 years, and the mean observational period was 13.2 ± 6.5 years. The maximum coronary artery internal diameter ranged from 6.1 to 25mm (median 9mm). Giant coronary aneurysm was 57 patients (68.7%) and large coronary aneurysm (6-8mm) was 26 patients (31.3%). Coronary aneurysms had progressed to coronary artery stenosis and/or complete occlusion in 42 patients (50.6%). The overall freedom from coronary intervention, coronary artery bypass surgery, or coronary thrombi was respectively 85.5%, 85.5%, and 90.3%. Catheter and surgical coronary interventions (median 1 intervention; range 1 to 5 interventions) were performed in 20 patients (24.1%) at 9 month to 18 years after onset, resulting in 33.7% cumulative coronary intervention rates at 20 years after onset. There were no differences in cumulative coronary intervention rates between two coronary aneurysm groups (6-8mm vs ≥8mm). Myocardial infarction occurred in 8 (8.98 %) patients. During this study period, 1 patient died and 98% survival rates was seen in our patients group. Conclusion: The long-term survival of patients with Kawasaki disease complicated by large coronary aneurysm is good even though a fourth of patients underwent multiple catheter or surgical interventions. Further research should focus on the indications for and effectiveness of percutaneous and surgical coronary interventions in large coronary aneurysm (≥ 6mm).

scholarly journals Combination Thrombolytic and Anti-Platelet Therapies in an Infant with Incomplete Kawasaki Disease and Coronary Aneurysms

2008 ◽  
Vol 13 (4) ◽  
pp. 242-250
Author(s):  
Peter N. Johnson ◽  
Robert J. Kuhn
Keyword(s):  
Septic Shock ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Thrombus Formation ◽  
Coronary Aneurysm ◽  
Intravenous Immunoglobulins ◽  
Minimal Change ◽  
Incomplete Kawasaki Disease ◽  
Persistent Fever ◽  
Coronary Aneurysms

A 3-month-old infant was transferred to our facility with persistent fever and concerns for septic shock. A 2-D echocardiogram revealed multiple coronary aneurysms and axillary and coronary artery thrombi, and a diagnosis of incomplete Kawasaki disease (KD) was established. Aggressive therapies including intravenous immunoglobulins, enoxaparin, abciximab, aspirin, and alteplase were used to decrease the size of the coronary aneurysms and inhibit further thrombus formation. After minimal change in the size of coronary aneurysms and in thrombus formation, clopidogrel was added. Approximately 2 weeks after initiation of these therapies, a decrease in the coronary aneurysm size was noted with no signs of thrombus. This case documents successful use of thrombolytic and combination anti-platelet agents (i.e., clopidogrel, abciximab, and aspirin) in an infant with KD and cardiovascular sequelae.

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