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coronary artery aneurysms caused by Kawasaki disease in an adult:A case report and literature review

World Journal of Clinical Cases 2022年第28期10卷 10266-10272页

作者： Ying He Hao Ji Jian-Chang Xie Liang Zhou The Fourth School of Clinical Medicine Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Cardiology Hangzhou First People's Hospital Affiliated to Zhejiang University School of MedicineHangzhou 310006Zhejiang ProvinceChina

BACKGROUND Kawasaki disease(KD) is a self-limiting febrile illness and an acute vasculitis with an unknown *** predominantly affects children aged < 5 *** is the common cause of acquired heart disease in *** here repo... 详细信息

BACKGROUND Kawasaki disease(KD) is a self-limiting febrile illness and an acute vasculitis with an unknown *** predominantly affects children aged coronary aneurysms with *** SUMMARY A 29-year-old female patient admitted to Hangzhou First People’s Hospital with coronary artery abnormality identified for 1 *** patient was asymptomatic;however,chest computed tomography occasionally revealed strip-like dense shadows in the coronal *** coronary angiography and Doppler echocardiography,the final diagnosis was coronary artery aneurysms(CAAs) caused by *** the patient was asymptomatic with no history of KD in childhood,the definitive diagnosis was CAAs caused by *** patient was administered anticoagulant,and surgical treatment was *** KD potentially causes CAAs in 25% of untreated cases,primarily occurring in the proximal portions of the coronary arteries.

关键词： Kawasaki disease coronary artery aneurysms coronary vasculitis coronary angiography Case report

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Evaluation of neointimal coverage in patients with coronary artery aneurysm formation after drug-eluting stent implantation by optical coherence tomography

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Chinese Medical Journal 2013年第11期126卷 2092-2097页

作者： TIAN Feng CHEN Yun-dai CHEN Lian SUN Zhi-jun GUO Jun JIN Qin-hua LIU Chang-N WANG Jin-da LIU Hong-bin Department of Cardiology Chinese People's Liberation ArmyGeneral Hospital Beijing 100853 China

Background The vessel healing in patients with coronary artery aneurysms （CAA） that form after drug-eluting stent （DES） implantation is not clear. This study aims to assess the vessel healing in patients with CAA formation after DES implanation. Methods From June 2008 to August 2011, follow-up coronary angiography was conducted on 1160 patients who underwent percutaneous coronary intervention （PCI）. The average period of follow-up was about （18.95±13.05） months. A total of 175 patients who underwent DES implantation into de novo lesions and who underwent coronary angiography and optical coherence tomography （OCT） examination during follow-up were identified. Patients were divided into the CAA group （n=31） and non-CAA group （n=144） based on the results of the coronary angiography. The cardiac events including angina and acute myocardial infarction were noted; in addition, the neointimal thickness and the frequency of strut malapposition and strut uncoverage were also noted. Results A greater proportion of incomplete neointimal coverage （17.17% vs. 1.90%, P 〈0.001） and strut malapposition （18.20% vs. 1.38%, P 〈0.001） were observed in the CAA group. The neointimal thickness in the CAA group was significantly thinner than that in the non-CAA group （（146.6±94.8） μm vs. （192.5＋97.1）μm, P 〈0.001）, as detected via OCT. Patients with CAA formation had a higher frequency of cardiac events including angina pectoris （25.81% vs. 6.25%, P=0.001） and acute myocardial infarction （9.68% vs. 0.13%, P=0.002） and thrombosis （16.13% vs. 0.69%, P 〈0.001）. The longitudinal length of the CAA in the cardiac event group was significantly longer than in the no cardiac event group （（20.0±9.07） mm vs. （12.05±5.38） ram, P=0.005）. Conclusion CAA formation after DES implantation is frequently associated with cardiac events as a result of stent malapposition and incomplete neointimal coverage.

关键词： optical coherence tomography coronary artery aneurysms drug-eluting stent neointimal coverage

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Corticosteroid Therapy Might be Associated with the Development of coronary Aneurysm in Children with Kawasaki Disease

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Chinese Medical Journal 2016年第8期129卷 922-928页

作者： Chun-Na Zhao Zhong-Dong Du Ling-Ling Gao Department of Cardiology Beijing Children’s Hospital Capital Medical University Beijing 100045 China Department of Pediatrics Key Laboratory of Major Diseases in Childhood Ministry of Education Beijing 100045 China

Background：coronary artery lesions （CALs） are known to be the main complication in children with Kawasaki disease （KD）.Instead of intravenous immunoglobulin （IVIG）,corticosteroid therapy has been accepted to be used for children with KD who are unresponsive to *** study aimed to evaluate risk factors for CALs in children with ***：We retrospectively reviewed the clinical records of 2331 children with KD from January 2005 to December *** identify the independent risk factors for CALs,multivariable logistic regression models were constructed using significant variables identified from univariate logistic regression ***：The incidence of CALs was 36.0% （840 of 2331）,including 625 （26.8%） coronary artery dilations and 215 （9.2%） coronary artery aneurysms （CAAs）.Multivariable logistic regression analysis identified that male,incomplete KD,longer fever duration,and C-reactive protein （CRP）〉 100 mg/L were independent risk factors for coronary artery *** the other hand,male,incomplete KD,longer fever duration,prolonged days of illness at the initial treatment,corticosteroid therapy,sodium ≤133 mmol/L,and albumin 〈35 g/L were the independent risk factors for *** addition,corticosteroid therapy,prolonged days of illness at the initial treatment,and albumin 〈35 g/L were the independent risk factors for giant ***：CALs might be associated with male sex,incomplete KD,longer fever duration,prolonged days of illness at the initial treatment,albumin 〈35 g/L,sodium ≤ 133 mmol/L,CRP 〉 100 mg/L,and corticosteroid *** therapy was an independent risk factor for CAAs and giant ***,corticosteroids should be used with caution in the treatment of KD with the risk for CALs.

关键词： coronary artery aneurysms coronary artery Lesions Corticosteroid Therapy Kawasaki Disease Risk Factors

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Influence of morphology and hemodynamics on thrombosis in kawasaki disease patients

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Medicine in Novel Technology and Devices 2023年第2期18卷 91-101页

作者： Haoyao Cao Zhuxiang Xiong Zhan Liu Yan Li Huaxia Pu Jing Liu Liqing Peng Tinghui Zheng Department of Mechanics Sichuan UniversityChengdu610065China Sichuan University Yibin Park Yibin Institute of Industrial TechnologyYibin644000China Department of Radiology West China HospitalSichuan UniversityChengdu610041China Med-X Center for Informatics Sichuan UniversityChengdu610041China

Kawasaki Disease(KD)patients with co-occurrent coronary artery aneurysms(CAAs)are prone to *** study explores the thrombotic influence of morphology and hemodynamics in KD patients with ***-specific computed tomography angiogram images of 9 patients were used to rebuild coronary models(including 23 aneurysms;10 in thrombosed group,and 13 in non-thrombosed group)and perform computational simulations to obtain the hemodynamic *** thrombosed and non-thrombosed groups were compared in terms of six parameters,namely,the maximum diameter(D_(max)),aspect ratio(R_(l/d)),shape,time-averaged wall shear stress(TAWSS),oscillatory shear index(OSI),and relative residence time(RRT).The results showed that:(1)In thrombosed aneurysms,there were several vortex structures(eddy zone),of which the position changed continuously in a cardiac *** non-thrombosed aneurysms,the streamlines showed a large streaming zone.(2)Abnormal hemodynamic areas of aneurysms with thrombosis tended to appear in the same region(especially the proximal and near myocardial side of aneurysms).(3)In the non-thrombosed group,there was a correlation between the morphological and hemodynamic *** thrombosed aneurysms,the flow pulsatility has a significant impact on the flow *** thrombosed coronary aneurysms exhibited more risk factors and the co-location of hemodynamic abnormalities was consistent with the position of thrombosis.A score of risk factors could provide the thrombotic information of coronary aneurysms,which might be helpful for long-term clinical management of KD patients.

关键词： coronary artery aneurysms Kawasaki disease Thrombotic risk stratification Morphology Hemodynamics

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