I-angioplasty kunye nokubekwa kwindawo entle-umthambo wecarotid

Imithambo yegazi ezisa igazi kwingqondo yakho nasebusweni ibizwa ngokuba yimithambo ye-carotid. Unomthambo we-carotid kwicala ngalinye lentamo yakho.

Ukuhamba kwegazi kulo mthambo kunokuba yinxalenye okanye kuthintelwe ngokupheleleyo zizinto ezinamanqatha ezibizwa ngokuba yicwecwe. Ukuvaleka ngokuyinxenye kuthiwa yicarotid artery stenosis (ukunciphisa). Ukuvaleka kwimithambo yakho ye-carotid kunokunciphisa ukuhanjiswa kwegazi kwingqondo yakho. Ngamanye amaxesha inxenye yeqweqwe linokuqhekeka lize livale omnye umthambo. Ukubetha kunokwenzeka xa ingqondo yakho ingafumani gazi laneleyo.

Iinkqubo ezimbini zinokusetyenziselwa ukuphatha umthambo we-carotid oncitshisiweyo okanye ovaliweyo. Zezi:

• Ugqirha lokususa i-plaque buildup (endarterectomy)
• ICarotid angioplasty enendawo ebekiweyo

I-Carotid angioplasty kunye ne-stenting (CAS) yenziwa kusetyenziswa ukusika okuncinci.

• Ugqirha wakho uya kwenza ukusika kotyando emva kokusebenzisa iyeza lokuqaqamba. Uya kunikwa neyeza ukuze ukhululeke.
• Ugqirha ubeka i-catheter (ityhubhu eguqukayo) ngokunqunyulwa kumthambo. Ihanjiswe ngononophelo ukuya entanyeni yakho ukuya kuthintelo kwimithambo yakho ye-carotid. Ukuhambisa imifanekiso ye-x-ray (i-fluoroscopy) isetyenziselwa ukubona umthambo kunye nokukhokelela kwi-catheter kwindawo efanelekileyo.
• Emva koko, ugqirha wotyando uya kususa ucingo kwi-catheter ukuya ekuvaleni. Enye ityhubhu enebhaluni encinci kakhulu ekugqibeleni iya kutyhalwa ngaphezulu kwale ngcingo kwaye ivale. Emva koko ibhaluni iyaphuphuma.
• Ibhaluni icinezela eludongeni lwangaphakathi lomthambo wakho. Oku kuvula umthambo kwaye kuvumela igazi elininzi ukuba liye kwingqondo yakho. I-stent (ityhubhu yocingo yocingo) inokufakwa kwindawo evaliweyo. I-stent ifakwe ngexesha elifanayo ne-balatheon catheter. Iyanda ngebhaluni. I-stent ishiywe endaweni yokunceda ukugcina umthambo uvulekile.
• Ugqirha ke uyayisusa ibhaluni.

Utyando lweCarotid (endarterectomy) yindlela endala kunye esebenzayo yokunyanga imithambo emxinwa okanye evaliweyo. Le nkqubo ikhuselekile kakhulu.

I-CAS iphuhlise njengenye indlela elungileyo yotyando, xa isenziwa ngabaqhubi abanamava. Izinto ezithile zinokuthanda ukuqaqamba, njengoku:

• Umntu ugula kakhulu ukuba angabinayo i-carotid endarterectomy.
• Indawo yokuncipha kwimithambo ye-carotid yenza utyando lube nzima.
• Umntu wayenentamo okanye utyando lwe-carotid ngaphambili.
• Umntu une radiation entanyeni.

Umngcipheko we-carotid angioplasty kunye nokubekwa kwesitent, okuxhomekeke kwizinto ezinje ngeminyaka, zezi:

• Ukunyanga komzimba kwidayi
• Amahlwili egazi okanye ukopha kwindawo yotyando
• Umonakalo wobuchopho
• Ukuxinana ngaphakathi kwestent (in-stent restenosis)
• Ukuhlaselwa yintliziyo
• Ukusilela kwezintso (umngcipheko ophezulu kubantu abasele beneengxaki zezintso)
• Ukuvaleka ngakumbi komthambo wecarotid ekuhambeni kwexesha
• Ukuxhuzula (oku kunqabile)
• Ukubetha

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba kwaye enze iimvavanyo zonyango ezininzi.

Soloko uxelela umboneleli wakho ukuba ngawaphi amayeza owathathayo, kubandakanya iziyobisi, izongezo, okanye amayeza owathengileyo ngaphandle kommiselo.

Ngexesha leeveki ezi-2 ngaphambi kwenkqubo yakho:

• Kwiintsuku ngaphambi kotyando, kungafuneka uyeke ukuthatha amayeza enza ukuba kube nzima kwigazi lakho ukuba lijiye. Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient) naprosyn (Aleve, Naproxen), kunye namanye amayeza afana nala.
• Buza umboneleli wakho ukuba ngawaphi amayeza ekufuneka uwathathe ngosuku lotyando lwakho.
• Ukuba uyatshaya, kufuneka uyeke. Buza umboneleli wakho ngoncedo lokuyeka.
• Soloko umboneleli wakho ekwazi malunga nokubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye esinye isigulo onokuba naso ngaphambi kotyando.

Ungaseli nantoni na emva kobusuku phakathi kobusuku ngaphambi kotyando lwakho, kubandakanya amanzi.

Ngomhla wotyando lwakho:

• Thatha amayeza oxelelwe ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Uzakuxelelwa ukuba ufike nini esibhedlele.

Emva kotyando, kuya kufuneka uhlale esibhedlele ubusuku bonke ukuze ujonge naziphi na iimpawu zokopha, ukubetha, okanye ukungahambi kakuhle kwegazi kwingqondo yakho.Unokwazi ukuya ekhaya kwangolo suku ukuba inkqubo yakho yenziwe kwangoko emini kwaye uqhuba kakuhle. Umboneleli wakho uya kuthetha nawe malunga nendlela yokuzikhathalela ekhaya.

Umthambo weCarotid angioplasty kunye nokuqaqamba kunokunceda ukunciphisa amathuba akho okuba nestroke. Kodwa kuya kufuneka wenze utshintsho kwindlela yokuphila ukuze uncede ukuthintela ukwakhiwa kweplate, amahlwili egazi, kunye nezinye iingxaki kwimithambo yakho yecarotid ekuhambeni kwexesha. Kuya kufuneka ukuba utshintshe indlela otya ngayo kwaye uqalise inkqubo yokuzilolonga ukuba umboneleli wakho ukuxelela ukuba umthambo ukhuselekile kuwe.

I-Carotid angioplasty kunye ne-stenting; CAS; I-angioplasty - umthambo we-carotid; Umthambo weCarotid stenosis - angioplasty

• Angina - ukubhobhoza
• UAngina-yintoni oza kuyibuza ugqirha wakho
• UAngina - xa unentlungu esifubeni
• I-Angioplasty kunye ne-stent-heart-discharge
• Iziyobisi Antiplatelet - P2Y12 inhibitors
• I-Aspirin kunye nesifo sentliziyo
• Ibhotolo, imajarini neeoli zokupheka
• Cholesterol kunye nendlela yokuphila
• Cholesterol - unyango lweziyobisi
• Ukulawula uxinzelelo lwegazi oluphezulu
• Kuchazwe amafutha ezempilo
• Iingcebiso zokutya okukhawulezayo
• Ukuhlaselwa yintliziyo - ukukhutshwa
• Ukuhlaselwa sisifo sentliziyo- ukubuza ugqirha
• Isifo sentliziyo - umngcipheko
• Ufunda njani iilebheli zokutya
• Ukutya okunetyuwa encinci
• Ukutya kweMeditera
• Unonophelo lwenxeba lotyando - luvulekile

• I-atherosclerosis yemithambo yangaphakathi ye-carotid
• ICarotid stenosis -I-X-ray yomthambo olungileyo
• Abavelisi beCholesterol

Aboyans V, uRicco JB, uBartelink MEL, et al. Ukukhetha komhleli - izikhokelo ze-ESC zango-2017 ekuchongeni nasekunyangeni izifo zemithambo-luvo, ngokusebenzisana noMbutho waseYurophu woNyango lweVascular (ESVS). I-Eur J Vasc Endovasc yoTyando. NgoJanuwari 2018; 55 (3): 305-368. IINKCUKACHA: 28851596 pubmed.ncbi.nlm.nih.gov/28851596/.

UBrott TG, uHalperin JL, u-Abbara S, et al. Ukuchaneka I-2011 ASA / ACCF / AHA / AANN / AANS / ACR / ASNR / CNS / SAIP / SCAI / SIR / SNIS / SVM / SVS isikhokelo kulawulo lwezigulana ezine-extracranial carotid kunye nesifo se-artebral artery disease: isishwankathelo sesigqeba: ingxelo yaseMelika Ikholeji yeCardiology Foundation / iAmerican Heart Association Task Force kwiZikhokelo zokuziqhelanisa, kunye neAmerican Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis UkuCinga nokuThintela, uMbutho weAriyadiyali yeAngiography kunye nongenelelo, uMbutho woNyango lweeRadiology, uMbutho weUkuhlinzwa ngokuNyanga, uMbutho weyeza leVascular, kunye noMbutho woNyango lweVascular. Iphuhliswe ngentsebenziswano neAmerican Academy ye-Neurology kunye noMbutho weComputer weComputer Tomography. ICatheter Cardiovasc Interv. Ngo-2013; 81 (1): E76-E123. IINKCUKACHA: 23281092 pubmed.ncbi.nlm.nih.gov/23281092/.

UBrott TG, uHoward G, uRoubin GS, et al. Iziphumo zexesha elide zokuqhafaza xa kuthelekiswa ne-endarterectomy ye-carotid-artery stenosis. N Engl J Med. Ngo-2016; 374 (11): 1021-1031. IINKCUKACHA: 26890472 pubmed.ncbi.nlm.nih.gov/26890472/.

IHicks CW, iMalas MB. Isifo seCerebrovascular: i-carotid artery stenting. Ku: Sidawy AN, Perler BA, ii-eds. Rutherford Uqhaqho lweMithambo kunye noNyango lwe-Endovascular. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2019: isahluko 92.

I-Kinlay S, iBhatt DL. Unyango lwezifo ze-vascoronary ezithintelayo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 66.

URosenfield K, uMatsumura JS, uChaturvedi S, et al. Ulingo olungenamsebenzi lwe-stent ngokuchasene notyando lwe-asymptomatic carotid stenosis. N Engl J Med. Ngo-2016; 374 (11): 1011-1020. IINKCUKACHA: 26886419 pubmed.ncbi.nlm.nih.gov/26886419/.