Ishii Masahiro, Ueno Takafumi, Ikeda Hisao, Iemura Motofumi, Sugimura Tetsu, Furui Jun, Sugahara Yoko, Muta Hiromi, Akagi Teiji, Nomura Yuichi, Homma Tomoki, Yokoi Hiroyoshi, Nobuyoshi Masakiyo, Matsuishi Toyojiro, Kato Hirohisa
Department of Pediatrics and the Cardiovascular Research Institute, Kurume University School of Medicine, Kurume, Japan.
Circulation. 2002 Jun 25;105(25):3004-10. doi: 10.1161/01.cir.0000019733.56553.d8.
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.
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.
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.
本研究旨在通过定量冠状动脉造影（QCA）和血管内超声成像评估川崎病导管介入治疗的序贯随访结果。
对22例患者（年龄2至24岁）的23处狭窄病变进行了导管介入治疗。4例患者接受了经皮球囊血管成形术（PBA），7例接受了支架植入，10例接受了经皮腔内冠状动脉旋磨术（PTCRA），2例接受了PTCRA与支架植入联合治疗。共有21处病变（91%）通过导管介入成功扩张，无重大或轻微并发症。1例患者因支架植入未能解决病变问题，立即接受了冠状动脉旁路移植术（CABG）。在导管介入治疗后4至6个月，2例接受PBA的患者经QCA检测发现2处再狭窄病变（9%），这些患者随后接受了CABG手术。在导管介入治疗后6个月至3年，无患者出现缺血表现。在导管介入治疗后3至4年，对14例患者的15处病变进行了QCA和血管内超声检查。2例患者经QCA检测发现2处再狭窄病变（13%）。其中1例接受了支架植入并接受了CABG手术，另1例接受了PTCRA并再次接受了PTCRA。13例患者在导管介入治疗后3至8年无缺血表现。
川崎病的导管介入治疗可以完成，且在短期内可能有效，但长期疗效有待进一步研究验证。
