Active aneurysm thrombosis after Kawasaki disease in an adult: Insight into anticoagulation therapy
Active aneurysm thrombosis after Kawasaki disease in an adult: Insight into anticoagulation therapy
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成人川崎病后活动性动脉瘤血栓形成：抗凝治疗的见解
DOI：
10.1016/j.jccase.2020.11.005
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发表时间：
2021
影响因子：
--
通讯作者：
Yamaguchi Osamu
中科院分区：
文献类型：
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作者：
Akazawa Yusuke;Inaba Shinji;Sakaue Tomohisa;Kurata Mie;Aono Jun;Yasugi Takumi;Moritani Tomozo;Nishiyama Hikaru;Higaki Takashi;Eguchi Mariko;Yamaguchi Osamu
成人川崎病（KD）继发全身动脉瘤的治疗仍然是一个治疗挑战。KD指南建议，当有巨大冠状动脉瘤或血栓形成史时，除抗血小板治疗外，还应使用华法林抗凝治疗。然而，长期使用华法林有几个问题。这个病例报告急性血栓闭塞由于巨大的动脉动脉瘤在成人KD。尽管使用华法林进行抗凝治疗，但由于复发性血栓事件，手术切除了动脉瘤。病理检查示动脉瘤内层状血栓伴炎症，因子Xa主要在新形成的血栓中表达。本研究为KD后心血管后遗症的抗凝治疗提供了新的思路。学习目的：本研究结合病理证据表明，Xa因子可能与川崎病后血栓形成事件有关
The management of systemic artery aneurysms secondary to Kawasaki disease (KD) in adults remains a therapeutic challenge. KD guidelines recommend the use of anticoagulation therapy with warfarin in addition to antiplatelet therapy when a giant coronary aneurysm or a history of thrombosis is documented. However, long-term use of warfarin presents several concerns. This case reports acute thrombotic occlusion due to the giant arterial aneurysm in an adult KD. A surgical resection of the aneurysm was performed because of recurrent thrombotic events, despite anticoagulant therapy with warfarin. Pathological examinations revealed a layered thrombus with inflammation in the aneurysm and Factor Xa expression mainly in newly formed thrombus. This study provides an insight into the anticoagulation therapy for cardiovascular sequelae after KD.<Learning objective:This study, along with pathological evidence, illustrates that Factor Xa might contribute to thrombotic events after Kawasaki disease.>