In vivo visualization of braid-like appearance in Kawasaki disease: insights from multi-modality imaging

A 42-year-old gentleman with Kawasaki disease was referred for silent cardiac ischemia at inferior myocardial region. Coronary angiography showed braid-like appearance in the right coronary artery. Several channels at the segment with braid-like appearance were visualized by multi-slice computed tomography and intravascular ultrasound. Interestingly in particular, optical coherence tomography visualized the presence of multiple micro-vessels which were not detectable on other modalities. This case further elucidates distinct morphological features of braid-like lesion which potentially influences blood supply and causing cardiac ischemia.