Kawasaki disease (KD) is an acute, self-limiting systemic vasculitis syndrome of unknown origin that mainly affects small and medium-sized arteries, particularly the coronary arteries, and is found primarily in infants and young children. Prompt diagnosis is critically important, because the incidence of coronary artery lesions (CAL) can be reduced by early treatment with IVIG. Increased echo-intensity of the coronary arterial (CA) wall was demonstrated in KD patients, and this finding is helpful
for diagnosis of KD. We evaluated the tissue characterization of the coronary artery wall quantitatively using acoustic densitometry for calculating the absolute echo-intensity of the coronary artery wall in patients with KD. The left coronary artery was visualized using acoustic densitometry. Intravascular ultrasound (IVUS) imaging of the coronary arteries now allows detailed visualization of CA wall morphology. We carefully examined CA wall morphology on long-term IVUS images in 70 KD patients. Long-term persistent coronary aneurysms and regressed coronary aneurysms after KD have abnormal vascular wall morphology. Such follow up should focus on the possible development of premature atherosclerosis and should include advice to the patients to avoid atherogenic risk factors. Acute and sequential follow-up results of percutaneous catheter intervention (PCI) for KD were also investigated. PCI for KD can be accomplished and is effective in the short-term and long-term follow-up periods. IVUS is useful for evaluating tissue characterization of CAL and for selecting the interventional strategy and follow-up. Long-term follow-up is necessary in KD patients, and attention should be paid to the possible development of premature atherosclerosis.