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(Circulation. 2002;105:3004.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Sequential Follow-Up Results of Catheter Intervention for Coronary Artery Lesions After Kawasaki Disease

Quantitative Coronary Artery Angiography and Intravascular Ultrasound Imaging Study

Masahiro Ishii, MD^*; Takafumi Ueno, MD^*; Hisao Ikeda, MD; Motofumi Iemura, MD; Tetsu Sugimura, MD; Jun Furui, MD; Yoko Sugahara, MD; Hiromi Muta, MD; Teiji Akagi, MD; Yuichi Nomura, MD; Tomoki Homma, MD; Hiroyoshi Yokoi, MD; Masakiyo Nobuyoshi, MD; Toyojiro Matsuishi, MD; Hirohisa Kato, MD

From the Department of Pediatrics and the Cardiovascular Research Institute (M. Ishii, M. Iemura, T.S., J.F., Y.S., H.M., T.A., H.K.) and Department of Internal Medicine III (T.U., H.I., T.H.), Kurume University School of Medicine, Kurume, Japan; Department of Pediatrics (Y.N.), Kagoshima University School of Medicine, Kagoshima, Japan; and Department of Cardiology (H.Y., M.N.), Kokura Memorial Hospital, Kokura, Japan.

Correspondence to Masahiro Ishii, MD, Kurume University School of Medicine, Department of Pediatrics, 67 Asahi-machi, Kurume 830, Japan. E-mail masaishi{at}med.kurume-u.ac.jp

Background— The purpose of this study was to assess the sequential follow-up results of catheter intervention in Kawasaki disease by use of quantitative coronary angiography (QCA) and intravascular ultrasound imaging.

Methods and Results— Catheter intervention was performed on 23 stenotic lesions in 22 patients (aged 2 to 24 years). Percutaneous balloon angioplasty (PBA) was performed in 4 patients, stent implantation in 7, percutaneous transluminal coronary rotational ablation (PTCRA) in 10, and a combination of PTCRA with stent implantation in 2. A total of 21 lesions (91%) were successfully dilated by catheter intervention without major or minor complications. One patient immediately underwent coronary artery bypass grafting (CABG) surgery because stent implantation failed to resolve his lesion. At 4 to 6 months after catheter intervention, 2 restenotic lesions (9%) were detected by QCA in 2 patients who had undergone PBA, and these patients subsequently underwent CABG surgery. In 6 months to 3 years after catheter intervention, no patients showed evidence of ischemic findings. At 3 to 4 years after catheter intervention, QCA and intravascular ultrasound studies were performed on 15 lesions in 14 patients. Two restenotic lesions (13%) were detected by QCA in 2 patients. One of the 2 had stent implantation and underwent CABG surgery, and the other had undergone PTCRA and underwent re-PTCRA. Thirteen patients demonstrated no ischemic findings at 3 to 8 years after catheter intervention.

Conclusion— Catheter intervention for Kawasaki disease can be accomplished and can be effective in the short term, but the long-term efficacy should be verified by further study.

Key Words: angioplasty • balloon • pediatrics

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