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Novel Percutaneous Coronary Intervention Techniques for Revascularizing Chronically Occluded Giant Coronary Aneurysms in a Patient with Kawasaki Disease

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Abstract

Kawasaki disease is a self-limiting vasculitis presenting in childhood that can lead to aneurysms of the coronary arteries. Patients who develop giant coronary aneurysms have a high incidence of coronary stenoses and occlusions resulting in myocardial ischemia. The mainstay of treatment for these lesions is surgical bypass due to complex coronary anatomy and a high rate of chronic total occlusions precluding traditional percutaneous coronary intervention techniques. We report the first successful percutaneous revascularization of two chronically occluded giant coronary aneurysms using the Hybrid Interventional Strategy for approaching chronic total occlusions. Both antegrade and retrograde dissection–reentry techniques were employed to fully revascularize two major epicardial arteries. Despite procedural success, longer-term vessel patency was not maintained following stent deployment highlighting the difficulty in maintaining durable results with percutaneous coronary intervention in this patient population.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA

    Zachary L. Steinberg, Thomas K. Jones & William L. Lombardi

  2. Division of Cardiology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA

    Thomas K. Jones

  3. University of Washington Medical Center, 1959 NE Pacific Street, Box 356171, Seattle, WA, 98195, USA

    Zachary L. Steinberg

Authors
  1. Zachary L. Steinberg
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  2. Thomas K. Jones
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  3. William L. Lombardi
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Corresponding author

Correspondence to Zachary L. Steinberg.

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Conflicts of interest

None of the authors report conflicts of interest related to this manuscript. Thomas K. Jones, MD, received research grant support, and he is consultant and scientific advisory board for Medtronic, Inc. William L. Lombardi, MD, is a consultant for Abbott Vascular, Boston Scientific, Abiomed, Vascular Solutions, and Asahi Intec and Roxwood Medical equity holder and his spouse is employed in Spectranetics.

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Steinberg, Z.L., Jones, T.K. & Lombardi, W.L. Novel Percutaneous Coronary Intervention Techniques for Revascularizing Chronically Occluded Giant Coronary Aneurysms in a Patient with Kawasaki Disease. Pediatr Cardiol 37, 1392–1395 (2016). https://doi.org/10.1007/s00246-016-1446-z

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  • DOI: https://doi.org/10.1007/s00246-016-1446-z

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