A Case of Intracoronary Collaterals Misinterpreted as Segmental Stenosis in Kawasaki Disease: Descriptive Method of Coronary Arterial Lesions

Chung, Hee Sun; Kim, Young Yoo; Kim, Seung Il; Kim, Jong Wan; Whang, Kyung Tai

Abstract

Visualization of coronary collaterals in coronary arteriography performed in vivo constitutes an important finding, and particularly in the presence of coronary artery disease, it allows observations related to the hemodynamic consequences of the disease process. Undoubtedly, the presence of collateral flow indicates that a compensatory mechanism has developed to ameliorate the detrimental effect of blood flow cessation due to obstruction of the arterial pathways. By definition, intracoronary collaterals are connections between branches of the same coronary artery. In general, in a coronary arteriogram obtained in vivo, their incidence is lower than that of intercoronary collaterals. We experienced a case of intracollateral circulation, seen extending from the aneurysm through the first segment filled with the right ventricular branch like vessels (OC, Seg 1. CL, intra. Seg 1-2. ANl, Seg 1. CL, inter. Seg 4-8.). Intercollaterals originated from the distal circumflex branch of the left coronary artery, passing through a posterior descending branch and later filled the right ventricular branch of the right coronary artery (OC, Seg 15. LSmd, Seg 6. ANm, Seg 6-7. CL, inter. Seg 15-4.) in a 9-year-old male with Kawasaki disease.