Hoʻokomo ʻia ka Angioplasty a me stent - carotid artery

ʻO nā kīʻaha koko e lawe i ke koko i kou lolo a me kou alo ua kapa ʻia nā aʻa carotid. Loaʻa iā ʻoe kahi aʻa carotid ma kēlā me kēia ʻaoʻao o kou ʻāʻī.

Hiki ke lilo i ke kahe o ke koko i loko o kēia aʻa a i ʻole ālai ʻia e nā mea momona i kapa ʻia he plake. Kapa ʻia kahi ālai hapa ʻia carotid artery stenosis (narrow). Hiki i kahi paʻa i kāu aʻa carotid ke hōʻemi i ka hāʻawi o ke koko i kou lolo. I kekahi manawa hiki i kahi ʻāpana o ka pālaki ke haki a ālai i ke aʻa ʻē aʻe. Hiki i kahi hōʻeha ke loaʻa ʻole i kou lolo ka lawa koko.

Hiki ke hoʻohana i nā kaʻina hana ʻelua e mālama i kahi aʻa carotid i hoʻopili ʻia a palaka paha. Eia nā:

• Hoʻopau ke ʻoki e wehe i ka plake buildup (endarterectomy)
• Carotid angioplasty me ka stent kau ʻana

Hana ʻia ʻo Carotid angioplasty a me stenting (CAS) me ka ʻoki ʻana i kahi ʻoki liʻiliʻi.

• E ʻokiʻoki kāu kaukipoki i kāu ʻoki ma hope o ka hoʻohana ʻana i kahi lāʻau numbing. Hāʻawi ʻia ʻoe i ka lāʻau e hoʻomaha ai iā ʻoe.
• Hoʻokomo ke kaukōkō i kahi catheter (kahi ʻōwili maʻalahi) ma o ka ʻokiʻoki ʻana i kahi aʻa. Hoʻoneʻe maikaʻi ʻia ia i kou ʻāʻī i ka paʻa i kāu aʻa carotid. Hoʻoneʻe ʻia nā kiʻi x-ray (fluoroscopy) e ʻike ai i ke aʻa a alakaʻi i ka catheter i kahi kūpono.
• ʻO ka mea aʻe, e neʻe ka mea lapaʻau i ka uea ma o ka catheter i ka paʻa. ʻO kahi catheter me kahi ʻōpala liʻiliʻi loa ma ka hopena e hoʻokuʻi ʻia i luna o kēia uea a i loko o ka paʻa. A laila hoʻonui ʻia ka pāluna.
• Kaomi ka baluna i ka paia o loko o kou aʻa. Wehe kēia i ke aʻa a hiki i ke kahe o ke kahe i kou lolo. Hiki ke kau ʻia kahi stent (a wire wire tube) i kahi i ālai ʻia. Hoʻokomo ʻia ka stent i ka manawa like me ka catheter balloon. Hoʻonui ia me ka baluna. Waiho ʻia ka stent i wahi e kōkua ai i ka hāmama o ke aʻa.
• Lawe ke kauka i ka pāluna.

ʻO ke kāpena Carotid (endarterectomy) kahi ala kahiko a maikaʻi hoʻi e mālama ai i nā aʻa ʻapi a i ʻole nā ​​ālai ʻia. Palekana loa kēia kaʻina hana.

Ua hoʻomohala ʻia ʻo CAS ma ke ʻano he koho ʻē aʻe i ke kaha ʻino, ke hana ʻia e nā ʻoihana ʻike. Kūpono kekahi mau kumu i ka stenting, e like me:

• Nui ka maʻi o ke kanaka i loaʻa i ka endartectomy carotid.
• ʻO ka wahi o ka piʻina i loko o ke aʻa carotid e paʻakikī ai ke kahakaha.
• He ʻāpana ʻāʻī a carotid paha kā kēlā kanaka i ka wā i hala.
• Ua loaʻa i ke kanaka ka radiation i ka ʻāʻī.

Nā pilikia o ka angotlasty carotid a me ka stent kau, i hilinaʻi ʻia i nā kumu e like me ka makahiki, ʻo ia:

• ʻO ka hopena āpau i ka pena
• Hoʻopili ke koko a hoʻokahe paha i ke kahua o ke kaha
• Poino lolo
• ʻO ke kāpae ʻana i ka loko o ka stent (restenosis in-stent)
• Maʻi hohola
• Nā hōʻino kīwī (ʻoi aku ka makaʻu i nā poʻe i loaʻa ka pilikia o ka hakuʻala)
• ʻO ka nui o ka paʻa o ke aʻa carotid ma kahi o ka manawa
• ʻO ka hopu ʻana (kakaʻikahi kēia)
• Hahau

E hana i kāu mea mālama ola i kahi hoʻokolohua kino a hana i kekahi mau hoʻokolohua olakino.

E haʻi mau i kāu mea hoʻolako i nā lāʻau āu e lawe nei, e like me nā lāʻau, nā mea hoʻopili, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau.

Ma nā 2 mau pule ma mua o kāu kaʻina hana:

• I mau lā ma mua o ke kaha ʻana, pono paha ʻoe e hōʻoki i ka lawe ʻana i nā lāʻau e paʻakikī ai i kou koko ke kō. Hoʻopili kēia i ka aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient) naprosyn (Aleve, Naproxen), a me nā lāʻau e like me kēia.
• E nīnau i kāu mea hāʻawi i nā lāʻau e pono ai ʻoe e lawe i ka lā o kou ʻoki ʻana.
• Inā puhi ʻoe, pono ʻoe e hoʻokū. E noi i kāu mea nāna e hāʻawi i ke kōkua no ka haʻalele.
• E hoʻomaopopo mau i kāu mea hoʻolako e pili ana i kekahi anuanu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe āu e loaʻa ai ma mua o kāu ʻoki.

Mai inu i kekahi mea ma hope o ke aumoe i ka pō ma mua o kāu ʻoki ʻana, me ka wai.

I ka lā o kou ʻoki kino:

• E lawe i nā lāʻau i kauoha ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

Ma hope o ke kahakaha ʻana, pono ʻoe e noho i ka haukapila i ka pō i hiki iā ʻoe ke kiaʻi ʻia no nā hōʻailona o ke kahe ʻana, ka hahau ʻana, a i ʻole ke kahe koko maikaʻi ʻole i kou lolo.Hiki paha iā ʻoe ke hoʻi i ka home i ka lā like inā hana mua ʻia kāu kaʻina hana i ka lā a ke maikaʻi nei ʻoe. E kamaʻilio kāu mea lawelawe iā ʻoe e pili ana i ka mālama ʻana iā ʻoe iho ma ka home.

Hiki i ka angioplasty a me ka stenting ke kōkua ke hoʻohaʻahaʻa i kou manawa e loaʻa ai kahi maʻi hahau. Akā pono ʻoe e hoʻololi i ke ʻano nohona e kōkua ai i ka pale ʻana i ka plake buildup, ke koko koko, a me nā pilikia ʻē aʻe i loko o nā aʻa o kou carotid ma kahi o ka manawa. Pono paha ʻoe e hoʻololi i kāu papaʻai a hoʻomaka i kahi papahana hoʻoikaika kino inā haʻi kāu mea hāʻawi iā ʻoe palekana i ka hoʻoikaika kino.

Carotid angioplasty a me ka stenting; CAS; Angioplasty - carotid artery; Stenosis ʻaʻa Carotid - angioplasty

• Angina - hoʻokuʻu
• Angina - he aha e nīnau aku ai i kāu kauka
• Angina - ke loaʻa iā ʻoe ka ʻeha o ka umauma
• Angioplasty a me stent - puʻuwai - hoʻokuʻu
• Nā lāʻau Antiplatelet - nā mea kūpaka P2Y12
• ʻO ka aspirin a me ka maʻi puʻuwai
• ʻO ka pata, ka margarine, a me nā aila kuke
• ʻO Cholesterol a me ka nohona
• Cholesterol - lāʻau lapaʻau
• Ke kaohi nei i kou kiʻekiʻe o ke koko
• Ua wehewehe ʻia nā momona momona
• ʻLelo aʻoaʻo ʻai wikiwiki
• Puʻuwai puʻuwai - hoʻokuʻu
• Ka hōʻeha puʻuwai - he aha e nīnau aku ai i kāu kauka
• Maʻi maʻi puʻuwai - nā mea weliweli
• Pehea e heluhelu ai i nā lepili ʻai
• Papaʻai paʻakai haʻahaʻa
• Papaʻai Mediterranean
• Mālama ʻeha ʻeha - wehe

• Atherosclerosis o nā aʻa carotid i loko
• Carotid stenosis - X-ray o ke aʻa pono
• Nā mea hana Cholesterol

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Brott TG, Halperin JL, Abbara S, et al. 2011 ASA / ACCF / AHA / AANN / AANS / ACR / ASNR / CNS / SAIP / SCAI / SIR / SNIS / SVM / SVS alakaʻi ma ka mālama ʻana i nā mea maʻi me ka carotid extracranial a me ka maʻi vertebral artery: hōʻuluʻulu mana: kahi hōʻike o ka ʻAmelika. Ke Kulanui o Cardiology Foundation / ʻAmelika Hui Pū ʻIa ʻAmelika Hui Pū ʻIa e pili ana i nā Kumu Hoʻomaʻamaʻa, a me ka American Stroke Association, ʻAmelika Hui Pū ʻIa Neurosains, ʻAmelika ʻAmelika o nā Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, ʻAha Kūkā o Neurological Surgeons, Society of Atherosclerosis ʻO ke kiʻi a me ka pale ʻana, ka ʻahahui no ka Angiography Cardiovascular a me nā hana, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, a me Society for Vascular Surgery. Hoʻomohala ʻia i ka laulima ʻana me ka American Academy of Neurology and Society of Cardiovascular Compute Tomography. ʻO Catheter Cardiovasc Interv. 2013; 81 (1): E76-E123. PMID: 23281092 pubmed.ncbi.nlm.nih.gov/23281092/.

Brott TG, Howard G, Roubin GS, et al. Nā hopena lōʻihi o ka stenting vs. endarterectomy no ka stotosis carotid-artery. N Engl J Med. 2016; 374 (11): 1021-1031. PMID: 26890472 pubmed.ncbi.nlm.nih.gov/26890472/.

Hicks CW, Malas MB. ʻO ka maʻi Cerebrovascular: stenting artery carotid. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 92.

Kinlay S, Bhatt DL. Hoʻomaʻamaʻa i ka maʻi non voronary vascular obstructive maʻi. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 66.

Rosenfield K, Matsumura JS, Chaturvedi S, et al. ʻO ka hoʻokolohua kaulike ʻana o ka stent me ke kaha ʻana no stenosis carotid asymptomatic. N Engl J Med. 2016; 374 (11): 1011-1020. PMID: 26886419 pubmed.ncbi.nlm.nih.gov/26886419/.