Hemodynamic factors of thrombus formation in coronary aneurysms associated with Kawasaki disease

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Abstract
Background: We studied the mechanism of thrombus formation in coronary aneurysms based on rheological findings. Methods: We studied 43 coronary aneurysms in 33 patients with Kawasaki disease (mean (± SD) age 6.1~4.3 years). These lesions were divided into three groups on the basis of maximum diameter: (i) small (group S); (ii) medium sized (group M); and (iii) large (group L) aneurysms. Using a Doppler flow guidewire and a pressure-monitoring guidewire, we measured coronary flow velocity and perfusion pressure inside aneurysms and in adjacent normal-looking vessels. We calculated the average peak velocity (APV) index, the mean coronary perfusion pressure (P) index and shear index. Results: The APV index and shear index decreased significantly (pConclusions: The results of the present study suggest that the stagnation of flow and the reduction of shear stress in coronary aneurysms could initiate thrombus formation.