National Japanese survey of thrombolytic therapy selection for coronary aneurysm: Intracoronary thrombolysis or intravenous coronary thrombolysis in patients with Kawasaki disease

2013 ◽  
Vol 55 (6) ◽  
pp. 690-695 ◽  
Author(s):  
Mana Harada ◽  
Katsumi Akimoto ◽  
Shunichi Ogawa ◽  
Hitoshi Kato ◽  
Yosikazu Nakamura ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Thrombolytic Therapy ◽  
Coronary Aneurysm ◽  
Coronary Thrombolysis ◽  
Intracoronary Thrombolysis ◽  
Selection For

Thrombolysis in the treatment of patients with Kawasaki disease

1993 ◽  
Vol 3 (3) ◽  
pp. 207-215 ◽  
Author(s):  
Atsuko Suzuki ◽  
Kamiya Tetsuro ◽  
Yasuo Ono ◽  
Yoshihisa Kinoshita
Keyword(s):  
Kawasaki Disease ◽  
Myocardial Ischemia ◽  
Thrombolytic Therapy ◽  
Coronary Aneurysm ◽  
Coronary Arteriography ◽  
The Other ◽  
Myocardial Imaging ◽  
Coronary Aneurysms ◽  
Large Coronary Arteries

AbstractThrombolysis was used in 13 procedures to treat eight patients with massive thrombosis of coronary aneurysms due to Kawasaki disease. The patients have now been followed for periods ranging from 2.5 years to 7.4 years subsequent to treatment. The procedures included intracoronary or intravenous infusion of urokinase and intravenous administration of tissue plasminogen activator. Thallium myocardial imaging, coronary arteriography and echocardiography were used for evaluation of the efficacy of the therapy and for follow-up studies. The latest time of treatment was 17 months after the onset of the disease. No new formation of massive thrombus was observed in any of the aneurysms. In five patients, eight of 13 procedures were judged to be successful. In the four patients with symptoms of myocardial ischemia, thrombolysis was undertaken immediately after the onset of symptoms. In the other patient, thrombolysis was attempted 36 days after the onset and produced remarkable improvement in the degree of ischemia. In the other four patients with no symptoms of ischemia, the therapy was undertaken when thrombus was detected in a coronary aneurysm. Aortocoronary bypass surgery was undertaken subsequent to the thrombolytic therapy in three patients, but proved satisfactory in only one patient. At follow-up, five patients have shown improvement in the degree of myocardial ischemia after treatment. Our results suggest that careful observation is needed to detect formations of thrombus in large coronary arteries for at least 1½ years after the onset of Kawasaki disease. Even if repeated thrombolytic therapy is required, it seems to be effective in checking the progression of ischemic heart disease.

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

Kawasaki disease complicated by cerebral infarction

2003 ◽  
Vol 13 (1) ◽  
pp. 103-105 ◽  
Author(s):  
Kenji Suda ◽  
Masahiko Matsumura ◽  
Shigeru Ohta
Keyword(s):  
Kawasaki Disease ◽  
Cerebral Infarction ◽  
Clinical Situation ◽  
Sudden Onset ◽  
X Ray ◽  
Coronary Aneurysms ◽  
Intracoronary Thrombolysis ◽  
Tissue Plasminogen ◽  
X Ray Computed ◽  
The Right

An 8-month-old boy presented with right hemiplegia of sudden onset after 20 days of Kawasaki disease, which was not initially treated by gamma globulin. Cranial X-ray computed tomography confirmed cerebral infarction as the cause of the right hemiplegia. In subsequent weeks, he developed multiple thromboses in coronary aneurysms. He successfully underwent intracoronary thrombolysis using tissue plasminogen activator without haemorrhagic complications. Cerebral infarction as a complication of Kawasaki disease is rare, and is a difficult clinical situation to manage.

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

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
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