What is the clinical evidence from this study?

Study design: Case Report. Population: Kawasaki Disease with giant coronary artery aneurysm and thrombosis (n=1). Intervention: Intracoronary thrombolysis (ICT) combined with systemic intravenous thrombolysis (IVCT). Primary outcome: Reperfusion and clinical outcome.

What does this research mean for the field?

Intracoronary thrombolysis can achieve partial reperfusion without procedural complications following failed systemic intravenous thrombolysis in pediatric Kawasaki disease complicated by coronary thrombosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

December 24, 2024Catheterization and Cardiovascular InterventionsOpen Access

Intracoronary Tissue Plasminogen Activator Therapy to Treat Thrombotic Occlusion of a Giant Coronary Aneurysm in Early Kawasaki Disease

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Key result

Intracoronary thrombolysis achieves safe partial reperfusion after failed systemic thrombolysis in infant Kawasaki thrombosis.

Why the study?

Thrombolytic therapy is commonly used in adult coronary syndromes but its application in pediatric Kawasaki Disease with coronary thrombosis remains poorly studied.

Does intracoronary thrombolysis improve reperfusion in pediatric Kawasaki Disease patients with coronary thrombosis?

Comparison

Intracoronary thrombolysis following failed systemic intravenous thrombolysis

Design

Single case report

Follow-up

18 months

Authors

PMPatrizio MorasBambino Gesù Children's Hospital PMPilati MaraBambino Gesù Children's Hospital MRMicol RebonatoLung Institute

Discussion

Member takes

Implication

May support intracoronary thrombolysis as rescue in infant KD thrombosis; hypothesis-generating and should not yet change practice.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Does intracoronary thrombolysis improve reperfusion in pediatric Kawasaki Disease patients with coronary thrombosis?

Population

A 9-month-old infant with Kawasaki Disease and giant coronary artery aneurysm complicated by a subocclusive thrombus in the LAD, followed for 18 months.

Intervention

Intracoronary thrombolysis (ICT) with tissue plasminogen activator (alteplase) following failed systemic intravenous thrombolysis (IVCT).

Outcome

Reperfusion and clinical status at 18 months follow-up.

Intracoronary thrombolysis may be a feasible rescue strategy for coronary thrombosis in pediatric Kawasaki Disease when systemic thrombolysis fails.

Limitations

Single case observation, findings cannot be generalized
Single observation
Findings cannot be generalized

Cite This Study

Moras et al. (2024) conducted a case report in Kawasaki Disease with giant coronary artery aneurysm and thrombosis (n=1). Intracoronary thrombolysis (ICT) combined with systemic intravenous thrombolysis (IVCT) was evaluated on Reperfusion and clinical outcome. Intracoronary thrombolysis following failed intravenous thrombolysis achieved partial reperfusion without complications in a 9-month-old infant with Kawasaki disease and coronary thrombosis.

synapsesocial.com/papers/6ab7391a3decb6a614ebbaac https://doi.org/10.1002/ccd.31382

Topics

STEMI management Chronic total occlusion PCI

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Intracoronary Tissue Plasminogen Activator Therapy to Treat Thrombotic Occlusion of a Giant Coronary Aneurysm in Early Kawasaki Disease

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Intracoronary Tissue Plasminogen Activator Therapy to Treat Thrombotic Occlusion of a Giant Coronary Aneurysm in Early Kawasaki Disease

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider