Sebaka sa Angioplasty le stent - mothapo oa carotid

Methapo ea mali e tlisang mali bokong le sefahlehong sa hau e bitsoa methapo ea carotid. U na le methapo ea carotid ka lehlakoreng le leng la molala oa hau.

Phallo ea mali mothapong ona e ka koaloa kapa ea koaloa ka botlalo ke mafura a bitsoang plaque. Thibelo e sa reroang e bitsoa carotid artery stenosis (narrowing). Thibelo ea methapo ea hau ea carotid e ka fokotsa phepelo ea mali bokong ba hau. Ka linako tse ling karolo ea lejoe e ka robeha 'me ea thiba mothapo o mong. Leqeba le ka hlaha haeba boko ba hao bo sa fumane mali a lekaneng.

Mekhoa e 'meli e ka sebelisoa ho phekola methapo ea carotid e patisaneng kapa e koetsoeng. Tsena ke:

• Ho buoa ho tlosa plaque buildup (endarterectomy)
• Carotid angioplasty e nang le stent placement

Carotid angioplasty le stenting (CAS) e etsoa ka mokhoa o monyane oa ho buoa.

• Ngaka ea hau e buoang e tla u khaola ka mor'a ho sebelisa moriana o fokolisang. U tla fuoa meriana ea ho u phomotsa.
• Ngaka e buoang e kenya catheter (tube e tenyetsehang) ka ho seha mothapo. E tsamaisoa ka hloko ho fihla molaleng oa hau ho koala methapo ea hau ea carotid. Ho tsamaisa litšoantšo tsa x-ray (fluoroscopy) ho sebelisoa ho bona mothapo le ho tataisetsa catheter sebakeng se nepahetseng.
• Ka mor'a moo, ngaka e buoang e tla tsamaisa terata ka catheter ho ea thibela. Catheter e 'ngoe e nang le balune e nyane haholo qetellong e tla sutumelletsoa holim'a terata ena le ho thiba. Ebe balune ea tšeloa moea.
• Balune e hatella leboteng le kahare la mothapo oa hau. Sena se bula mothapo 'me se lumella mali a mangata ho phallela bokong ba hau. Stent (terata ea terata e terata) le eona e ka beoa sebakeng se thibetsoeng. Stent e kenngoa ka nako e ts'oanang le catheter ea ballo. E atoloha ka balune. Stent e setse sebakeng sa eona ho thusa ho boloka mothapo o butsoe.
• Joale ngaka e buoang e tlosa balune.

Ho buuoa ka Carotid (endarterectomy) ke mokhoa oa khale le o sebetsang oa ho phekola methapo e mosesane kapa e koetsoeng. Tsamaiso ena e bolokehile haholo.

CAS e thehiloe e le mokhoa o mong o motle oa ho buoa, ha o etsoa ke baetsi ba nang le boiphihlelo. Lintlha tse ling li ka rata ho hlonama, joalo ka:

• Motho o kula haholo hore a ka ba le carartid endarterectomy.
• Sebaka sa ho fokotseha ha methapo ea carotid ho etsa hore ho buuoa ho be thata le ho feta.
• Motho eo o kile a etsoa opereishene ea molala kapa ea carotid nakong e fetileng.
• Motho o na le radiation maqhubu molaleng.

Likotsi tsa carotid angioplasty le ho beha stent, ho ipapisitseng le lintlha tse kang lilemo, ke:

• Allergic reaction ho dae
• Ho koala mali kapa ho tsoa mali sebakeng sa bongaka
• Tšenyo ea boko
• Ho koaheloa ka hare ho stent (in-stent restenosis)
• Lefu la pelo
• Ho hloleha ha liphio (kotsi e kholo ho batho ba seng ba ntse ba na le mathata a liphio)
• Thibelo e eketsehileng ea mothapo oa carotid ha nako e ntse e tsamaea
• Ho oa (sena ke seoelo)
• Leqeba

Mofani oa hao oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele le ho etsa liteko tse' maloa tsa bongaka.

Kamehla bolella mofani oa hau hore na ke meriana efe eo u e sebelisang, ho kenyelletsa lithethefatsi, litlatsetso kapa litlama tseo u li rekileng ntle le lengolo la ngaka.

Nakong ea libeke tse 2 pele ho ts'ebetso ea hau:

• Matsatsi pele ho opereishene, o kanna oa tlameha ho emisa ho noa meriana e etsang hore ho be thata hore mali a hao a koalehe. Tsena li kenyelletsa aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient) naprosyn (Aleve, Naproxen), le meriana e meng e kang ena.
• Botsa mofani oa hau hore na ke meriana efe eo u lokelang ho e nka ka letsatsi la ts'ebetso ea hau.
• Haeba u tsuba, u lokela ho emisa. Botsa mofani oa hau thuso ea ho tlohela.
• Kamehla lumella mofani oa hau hore a tsebe ka serame, feberu, feberu, ho tsoa ha herpes, kapa bokuli bo bong boo u ka bang le bona pele u etsoa opereishene.

U SE KE ua noa letho kamora khitla bosiu pele u etsoa opereishene, ho kenyeletsoa le metsi.

Letsatsing la ho buuoa:

• Nka meriana eo u laetsoeng ho e noa ka ho noa metsi hanyane.
• O tla bolellwa nako ya ho fihla sepetlele.

Kamora ho buuoa, o kanna oa hloka ho robala sepetlele bosiu bo le bong e le hore o tle o shejoe matšoao afe kapa afe a ho tsoa mali, ho hlaseloa ke lefu, kapa phallo e mpe ea mali bokong ba hau.U kanna oa khona ho khutlela hae ka lona letsatsi leo haeba ts'ebetso ea hau e entsoe hoseng 'me u ntse u sebetsa hantle. Mofani oa hau o tla bua le uena ka mokhoa oa ho itlhokomela lapeng.

Carotid artery angioplasty le stenting li ka thusa ho theola menyetla ea hau ea ho ba le stroke. Empa o tla hloka ho etsa liphetoho tseleng eo u phelang ka eona ho thusa ho thibela ho bokellana ha lejoe, ho koaloa ha mali le mathata a mang methapong ea hau ea carotid ha nako e ntse e tsamaea. U kanna ua hloka ho fetola tsela eo u jang ka eona 'me u qale lenaneo la boikoetliso haeba mofani oa hau au joetsa hore boikoetliso bo bolokehile bakeng sa hau.

Carotid angioplasty le stenting; CAS; Angioplasty - mothapo oa carotid; Carotid artery stenosis - angioplasty

• Angina - ho tsoa
• Angina - seo u lokelang ho se botsa ngaka ea hau
• Angina - ha o na le bohloko ba sefuba
• Angioplasty le stent - pelo - lero
• Lithethefatsi tsa antiplatelet - P2Y12 inhibitors
• Aspirin le lefu la pelo
• Botoro, majarine le oli ea ho pheha
• Cholesterol le mokhoa oa bophelo
• Cholesterol - kalafo ea lithethefatsi
• Ho laola khatello ea mali e phahameng
• Ho hlalositsoe mafura a phepo
• Malebela a lijo tse potlakileng
• Lefu la pelo - ho tsoa
• Lefu la pelo - seo u lokelang ho se botsa ngaka ea hau
• Lefu la pelo - lisosa tse kotsi
• Mokhoa oa ho bala mangolo a lijo
• Lijo tse nang le letsoai le tlase
• Lijo tsa Mediterranean
• Tlhokomelo ea leqeba la ho buoa - e bulehile

• Atherosclerosis ea methapo ea ka hare ea carotid
• Carotid stenosis - X-ray ea mothapo o nepahetseng
• Bahlahisi ba k'holeseterole

Aboyans V, Ricco JB, Bartelink MEL, et al. Khetho ea Mohlophisi - Litaelo tsa 2017 ESC mabapi le tlhahlobo le kalafo ea mafu a methapo, ka ts'ebelisano le European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Ts'ebetso. 2018; 55 (3): 305-368. PMID: 28851596 phatlalalitsoe.ncbi.nlm.nih.gov/28851596/.

Brott TG, Halperin JL, Abbara S, le al. 2011 ASA / ACCF / AHA / AANN / AANS / ACR / ASNR / CNS / SAIP / SCAI / SIR / SNIS / SVM / SVS tataiso mabapi le taolo ea bakuli ba nang le lefu la methapo ea methapo ea methapo ea methapo: kakaretso ea phethahatso: tlaleho ea Amerika College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines, le American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, Mokhatlo oa Amerika oa Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Ho nahanisisa le ho Thibela, Mokhatlo oa Phekolo ea Metsing le Mekhoa ea Metsing, Mokhatlo oa Radiology ea Ts'ebetso, Mokhatlo oa NeuroInterventional Surgery, Mokhatlo oa Vascular Medicine le Mokhatlo oa Phekolo ea Vascular. E thehiloe ka ts'ebelisano le American Academy of Neurology le Society of Cardiovascular Computed Tomography. Catheter Cardiovasc Nako. 2013; 81 (1): E76-E123. PMID: 23281092 phatlalalitsoe.ncbi.nlm.nih.gov/23281092/.

Brott TG, Howard G, Roubin GS le ba bang. Liphetho tsa nako e telele tsa stenting le endarterectomy bakeng sa carotid-artery stenosis. N Engl J Med. 2016; 374 (11): 1021-1031. PMID: 26890472 e fetotsoe.ncbi.nlm.nih.gov/26890472/.

Hicks CW, Malas MB. Boloetse ba methapo ea pelo: methapo ea carotid e hlabang. Ka: Sidawy AN, Perler BA, bahlophisi. Rutherford's Vasculry and Endovascular Therapy. La 9th. Philadelphia, PA: Elsevier; 2019: khaolo ea 92.

Kinlay S, Bhatt DL. Kalafo ea lefu la methapo e sa sebetseng e sa sebetseng. Ka: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Lefu la pelo la Braunwald: Buka ea bongaka ea meriana ea pelo. 11th ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 66.

Rosenfield K, Matsumura JS, Chaturvedi S, le al. Teko e sa reroang ea stent le ho buuoa bakeng sa asymptomatic carotid stenosis. N Engl J Med. 2016; 374 (11): 1011-1020 (Khatisitsoeng) PMID: 26886419 phatlalalitsoe.ncbi.nlm.nih.gov/26886419/.