During the past 15 years, clinical experience with
catheter interventional treatment in patients with
Kawasaki disease, including balloon angioplasty,
stent implantation, rotational ablation, and transluminal coronary revascularization, has been gradually increasing. Because the coronary artery lesions in
Kawasaki disease involve severe calcifications, the indications or
catheter intervention techniques have not been established for adult patients with
Kawasaki disease. Satisfactory acute results for coronary balloon angioplasty have been obtained in patients with a relatively short interval from the onset of disease, especially within 6 years; however, the incidence of restenosis after angioplasty is still high. Rotational ablation may be the most appropriate
catheter intervention technique for patients with
Kawasaki disease. The advantage of rotational ablation is the high success rate, even in patients with calcified
coronary artery stenosis.
Stent implantation requires larger arterial access and is not possible in younger children. Care should be paid to the detection of newly-formed
aneurysms, as the formation of new
aneurysms is associated with the use of additional balloon angioplasty using high pressure balloon inflation. Anticoagulation or anti-platelet regimens are essential for long-term management. Coronary intervention in
Kawasaki disease requires special techniques and knowledge of cardiovascular involvement. The procedure should be managed under the close collaboration between pediatric cardiologists and coronary interventional cardiologists.