Te whakanoho i te Angioplasty me te taikaha - carotid artery

Ko nga oko toto e kawe ana i te toto ki to roro me to kanohi e kiia ana ko nga hiko o te carotid. Kei o taha o to kaki tetahi toenga hiko.

Ko te rere o te toto i roto i tenei uaua ka aukatihia e tetahi mea momona ranei e kiia nei ko te tohu. Ko te aukati waahanga ka kiia ko te carotid arter stenosis (whaiti). Ma te aukati i to uaua o te motuka ka iti ake te whakaheke o te toto ki to roro. I etahi wa ka pakaru te waahanga o te tohu ka aukati i tetahi atu uaua. Ka pa te mate whiu ki te kore e nui te toto o to roro.

E rua nga tikanga ka taea te whakamahi hei whakaora i te uaua o te carotid e kuiti ana, e aukatia ana ranei. Ko enei:

• Te taahiraa ki te tango i te hanga tohu (endarterectomy)
• Angioplasty Carotid me te whakanoho i te stent

Ka whakamahia te angioplasty me te stenting (CAS) ma te tapahi iti i te pokanga.

• Ka tapahia e to taakuta te tapahi i roto i to kokiri i muri i te whakamahinga o te rongoa koretake. Ka hoatu hoki he rongoa ki a koe kia waatea ai koe.
• Ka tuu e te kaiakuta he catheter (he ngongo ngawari) ma te tapahi ki roto i te uaua. Ka aata nekehia atu ki to kakii ki te aukati i roto i to kaokao motuka. Ko te neke i nga pikitia hihi-hihi (fluoroscopy) ka whakamahia kia kite i te kopere ka arahi i te pouaka ki te tuunga tika.
• Muri iho, ka nekehia e te taakuta taura te waea i roto i te pouaka ki te aukati. Ko tetahi atu catheter me te poihau iti rawa i te pito ka panaia ki runga i tenei waea ka uru ki te aukati. Katahi ka pupuhi te poihau.
• Ka peehi te poihau ki te pakitara o roto o to kopae. Ma tenei ka whakatuwhera te kopere hiko ka nui ake te toto e rere ki to roro. Ka taea te whakanoho i te stent (ngongo ngongo waea) ki te rohe kua aukatia. Ka whakauruhia te stent i te wa kotahi ki te pouaka poihau. Ka whakawhanuitia me te poihau. Ka waihohia te stent kia tika ai te tuwhera o te uaua.
• Ka tango te taakuta i te poihau.

Ko te taahiraa o te Carotid (endarterectomy) he huarahi tawhito me te whai hua ki te hamani i nga uaua kuiti ka aukatia ranei. He tino haumaru tenei mahinga.

Kua whakawhanakehia te CAS hei whakakapi pai i te pokanga, ina ka mahia e nga kaiwhakaako mohio. Ko etahi ahuatanga ka pai ki te taatai, penei:

• Kei te mate te tangata kei te mate ia ki te whai i te karotid endarterectomy.
• Ko te waahi o te whaiti i roto i te uaua o te carotid ka uaua ake te pokanga.
• Ko te tangata kua oti te kaki te taatai ​​karotid ranei i mua.
• Kua pā mai te radiation ki te kakii o te tangata.

Nga morearea o te angioplasty carotid me te whakanoho i te stent, e pa ana ki nga ahuatanga penei i te tau:

• Tauhohenga mate pāwera ki te waikano
• Te whakaheke toto toto ranei kei te waahi o te pokanga
• Pakaru roro
• Te aukati i te taha o te stent (restenosis-a-roto)
• Te whakaeke ngakau
• Te ngoikoretanga o te tākihi (he morearea ki te hunga kua raru raru nei)
• He nui atu te aukati i te uaua o te motuka i roto i te roanga o te waa
• Te hopu (he onge tenei)
• Pakaru

Ka whakamātautau a-hauora to kaiwhakarato hauora me te maha o nga whakamatautau hauora.

Me korero tonu ki to kaiwhakarato he aha nga rongoa e inu ana koe, tae atu ki nga raau taero, taapiri, otaota ranei i hokona e koe me te kore he whakahaunga.

I roto i nga wiki e 2 i mua o to tikanga:

• I nga ra i mua o te pokanga, me mutu pea te tango i nga rongoa ka uaua ki te whakaheke toto. Kei roto i enei ko te aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient) naprosyn (Aleve, Naproxen), me etahi atu rongoa penei.
• Patai ki to kaiwhakarato ko tehea nga rongoa me kai e koe i te ra o to pokanga.
• Mena ka paowa koe, me mutu koe. Tonoa to kaiwhakarato kia awhina i a ia ki te whakamutu.
• Me korero tonu ki to kaiwhakarato mo tetahi makariri, rewharewha, kirika, whati herpes, me etahi atu mate ranei kei mua i a koe i to pokanga.

KAUA E inu i tetahi mea i muri o waenganui po i te po i mua o to pokanga, tae atu ki te wai.

I te ra o to pokanga:

• Tangohia nga rongoa kua ki atu ki a koe kia tangohia ma tetahi wahi iti o te wai.
• Ka korerohia ki a koe ahea tae atu ki te hohipera.

Whai muri i te pokanga, me noho pea koe ki te hohipera i te po kia tirohia ai koe mo nga tohu o te toto, te patunga, te rere toto ranei ki to roro.Akene ka taea e koe te hoki ki te kaainga i taua ra mena ka mahi wawe koe i te ra, kei te pai koe. Ka korero atu to kaiwhakarato ki a koe me pehea te tiaki i a koe ano i te kaainga.

Ko te angioplasty arataki Carotid me te taatai ​​te tikanga ka iti ake to tupono ka pa mai koe ki te whiu. Engari me whakarereke e koe te ahua o te noho hei aarai i te kohi papa, te whakaheke toto, me etahi atu raru i roto i o taakaro motuka i roto i te waa. Akene me whakarereke i to kai me te tiimata i tetahi kaupapa whakakori mena ka kii to kaiwhakarato he pai te ahurutanga maau.

Angioplasty Carotid me te wheriko; CAS; Angioplasty - motokoto carotid; Ko te stenosis arataki Carotid - angioplasty

• Angina - tuku
• Angina - he aha te paatai ​​ki to taakuta
• Angina - ka mamae koe i te uma
• Angioplasty me te taakaha - ngakau - tuku
• Nga rongoa antiplatelet - kaitautoko P2Y12
• Ahipirini me te mate ngakau
• Te pata, te margarine, me nga hinu tunu
• Cholesterol me te noho oranga
• Cholesterol - maimoatanga rongoa
• Te whakahaere i to toto toto toto
• Kua whakamaramahia nga momona kai
• Tohu awhina kai nohopuku
• Te mate ngakau - te tuku
• Te mate ngakau - he aha te paatai ​​ki to taakuta
• Nga mate ngakau - nga morearea morearea
• Me pehea te panui i nga tapanga kai
• Te kai iti-tote
• Te kai Mediterranean
• Tiaki patunga whara - tuwhera

• Atherosclerosis o te roto o te carotid
• Stenosis Carotid - X-hihi o te uaua katau
• Kaihanga Cholesterol

Aboyans V, Ricco JB, Bartelink MEL, et al. Te kowhiri a te Etita - Ko nga aratohu a te ESC 2017 mo te taatai ​​me te maimoatanga o nga mate pukupuku o te taha whanui, i te mahi tahi me te European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018; 55 (3): 305-368. PMID: 28851596 pubmed.ncbi.nlm.nih.gov/28851596/.

Brott TG, Halperin JL, Abbara S, et al. 2011 ASA / ACCF / AHA / AANN / AANS / ACR / ASNR / CNS / SAIP / SCAI / SIR / SNIS / SVM / SVS aratohu mo te whakahaere i nga tuuroro me te carotid extracranial me te mate vertebral artery: whakarapopototanga a te kaiwhakahaere College of Cardiology Foundation / American Heart Association Task Force mo nga Aratohu Mahi, me te American 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 Whakaahua me te Whakatupato, Te Hapori mo te Angiography Cardiovascular me nga Whakauru, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, me te Society for Vascular Surgery. I whakawhanakehia i te taha o te American Academy of Neurology me te Society of Cardiovascular Computed Tomography. Catheter Cardiovasc Interv. 2013; 81 (1): E76-E123. PMID: 23281092 pubmed.ncbi.nlm.nih.gov/23281092/.

Brott TG, Howard G, Roubin GS, et al. Nga hua mo te wa roa mo te stenting versus endarterectomy mo te stenosis carotid-artery. N Engl J Med. 2016; 374 (11): 1021-1031. PMID: 26890472 pubmed.ncbi.nlm.nih.gov/26890472/.

Hicks CW, Malas MB. Te mate Cerebrovascular: te whakaheke toto o te carotid. I roto i: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endotherapy Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: chap 92.

Kinlay S, Bhatt DL. Maimoatanga o te mate pukupuku aukati noncoronary I roto i: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. He Mate Ngakau a Braunwald: He Pukapuka Kupu mo te Mate Cardiovascular. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 66.

Rosenfield K, Matsumura JS, Chaturvedi S, et al. Whakamatauhia te whakamaarama o te taatai ​​me te taatai ​​mo te stenosis carotid asymptomatic. N Engl J Med. 2016; 374 (11): 1011-1020. PMID: 26886419 pubmed.ncbi.nlm.nih.gov/26886419/.