Why the study?
Coronary lesions associated with Kawasaki disease can be heavily calcified and present a therapeutic challenge.
Intravascular shockwave lithotripsy can be an effective treatment for heavily calcified coronary lesions secondary to Kawasaki disease that are refractory to other atherectomy techniques.
Kawasaki disease is a systemic vasculitis with frequent coronary artery involvement, associated with coronary artery aneurysms (CAAs) even if appropriately treated. Patients with CAA have a high risk for cardiovascular complications and frequently undergo repeated coronary interventions. Coronary lesions associated with Kawasaki can be heavily calcified, presenting a therapeutic challenge. We discuss the case of a 27-year-old patient who developed CAA and severe coronary artery calcifications despite appropriate treatment after Kawasaki disease when he was two years old. The coronary stenosis was heavily calcified and failed treatment with cutting balloons, orbital atherectomy, and rotational atherectomy, but yielded after being treated with intravascular lithotripsy. The patient was treated with drug-eluting stent and covered stent to exclude the CAA, with a good final result.
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Donisan et al. (2021) studied this question.
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