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Thrombolytic therapy in Kawasaki disease: a report of four cases

Mana Harada1, Katsumi Akimoto, Masao Otaka

  • 1Pediatrics and Adolescent Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|October 19, 2013
PubMed

Insights

Kawasaki disease (KD) patients with coronary artery aneurysms and thrombi can be treated with intravenous coronary thrombolysis (IVCT). While effective, IVCT is slower than intracoronary thrombolysis for thrombus resolution, except in acute myocardial infarction cases.

Area of Science:

  • Cardiology
  • Pediatric Rheumatology

Background:

  • Kawasaki disease (KD) can lead to coronary artery aneurysms.
  • Thrombus formation within these aneurysms poses a significant risk.

Observation:

  • Four patients with KD-associated coronary artery aneurysms and thrombi were treated between 1994 and 2009.
  • All patients received intravenous coronary thrombolysis (IVCT).
  • Cases with acute myocardial infarction received additional intracoronary thrombolysis.

Findings:

  • Both IVCT and intracoronary thrombolysis were effective in resolving thrombi.
  • IVCT demonstrated a longer thrombus resolution time compared to intracoronary thrombolysis.
  • IVCT is a viable first-line therapy for KD-related coronary thrombi, excluding acute myocardial infarction.

Implications:

  • IVCT can be considered a primary treatment for coronary artery thrombi in Kawasaki disease.
  • Intracoronary thrombolysis may be preferred for faster resolution in acute myocardial infarction cases.
  • This study highlights treatment strategies for a rare but serious complication of KD.

Keywords:
Kawasaki diseaseacute myocardial infarctionintracoronary thrombolysisintravenous coronary thrombolysistissue polypeptide antigen

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