Abstract
Catheter-based percutaneous coronary intervention (PCI) for atherosclerotic coronary artery disease in adult patients has been introduced into clinical practice since 1977, which has dramatically changed therapeutic strategy both in acute and chronic ischemic disease. Initial balloon angioplasty showed lots of limitations. Many efforts to overcome these limitations resulted in development of various types of new device in 1990s. Coronary stents increased success rate, decreased acute complications, expanded PCI indications and decreased restenosis. Atherectomy devices provided different approaches to treat coronary obstruction. Especially rotablator is the only effective device to treat severely calcified lesions. Currently nearly two million cases of PCI are estimated to be performed in the world. Overall mortality rate of recent PCI is less than 0.5% and major acute complications 2-3% despite of expanded indications, however, reintervention is still required in 10-20% of patients because of restenosis, which has been the Achilles heel since the beginning of PCI. Recent clinical trials of drug eluting stent reported no in-stent restenosis in drug-coated stent groups. It hopefully means that restenosis-free coronary intervention has come to reality. Coronary artery involvement is one of the most serious complications in Kawasaki disease (KD), about 4% of which is reported to develop ischemic events. KD in childhood is also supposed to be an increasing cause of coronary artery disease in adults, especially in young adults under 40 years of age. PCI has been successfully applied to manage coronary obstruction in KD children. Especially rotational atherectomy (rotablator) is effective for severely calcified lesions in KD children as well as in adult coronary intervention. Possible limitations and benefits of interventional treatment for ischemic events in KD children and in adult survivors of KD will be discussed, including the influence of recent advances in adult interventional cardiology.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yamaguchi, T. Recent Advances in Percutaneous Coronary Intervention for Ischemic Heart Disease. Pediatr Res 53, 158 (2003). https://doi.org/10.1203/00006450-200301000-00029
Issue Date:
DOI: https://doi.org/10.1203/00006450-200301000-00029