Maʻi maʻi aʻa Carotid

Hana ʻia ka maʻi o ke aʻa Carotid ke hele a puni a paʻa paha nā aʻa carotid.

Hāʻawi nā aʻa carotid i kahi ʻāpana o ke kumu o ke koko i kou lolo. Aia lākou ma kēlā me kēia ʻaoʻao o kou ʻāʻī. Hiki iā ʻoe ke haha ​​i ko lākou lāʻau i lalo o kou iwi ā.

Hana ʻia ka maʻi maʻi carotid artery ke kūkulu ʻia nā mea momona i kapa ʻia i loko o nā aʻa. Kapa ʻia kēia buildup o ka pāka he paʻakikī o nā aʻa (atherosclerosis).

Pākuʻi mālie paha ka pālākiō a hākiki paha i ke aʻa carotid. A i ʻole hoʻokumu ʻia i kahi ʻūpā e hana koke. Hiki i kahi ʻōpala ke ālai loa i ke aʻa ke alakaʻi i ka hahau.

ʻO nā kumu pilikia no ka pale ʻana a i ʻole ke kahaiki ʻana o nā aʻa i loko:

• Puhi (nā poʻe puhi i hoʻokahi pack i ka lā e pāpālua i ko lākou pilikia no ka hahau ʻana)
• Diabetes
• Piʻi koko kiʻekiʻe
• Kolesterol kiʻekiʻe a me nā triglycerides
• Makahiki
• ʻO ka mōʻaukala ʻohana o ka maʻi ʻōiwi
• Hoʻohana rama
• Hoʻohana lāʻau hoʻoliʻiliʻi
• Trauma i ka ʻāʻī, kahi e hoʻonā ai i ke aʻa carotid

I nā wā mua, ʻaʻohe ou mau ʻōuli. Ma hope o ke kūkulu ʻana o ka pāka, ʻo nā ʻōuli mua loa o ka maʻi carotid artery he maʻi hahau a i ʻole kahi hoʻouka ischemic kuewa (TIA). ʻO kahi TIA kahi hahau liʻiliʻi i kumu ʻole i kahi pōʻino mau loa.

ʻO nā ʻōuli o ka hahau a me TIA:

• ʻIke makapō
• Huikau
• Ka nalowale hoʻomanaʻo ʻana
• Lilo o ka naʻau
• Nā pilikia me ka ʻōlelo a me ka ʻōlelo, me ka nalowale ʻana o ka walaʻau
• Ka nalowale ʻana o ka hihiʻo (makapō hapa a piha paha)
• Ka nāwaliwali i hoʻokahi ʻāpana o kou kino
• Nā pilikia me ka noʻonoʻo, ka noʻonoʻo ʻana, a me ka hoʻomanaʻo ʻana

E hana i kāu mea mālama ola i kahi hoʻokolohua kino. Hiki paha i kāu mea hāʻawi ke hoʻohana i kahi stethoscope e hoʻolohe i ke kahe o ke koko i kou ʻāʻī no kahi leo ʻano ʻē i kapa ʻia he bruit. He hōʻailona paha kēia o ka maʻi carotid artery.

Loaʻa paha i kāu mea hāʻawi i nā huʻa i loko o nā kīʻaha koko o kou maka. Inā ua loaʻa ʻoe i ka maʻi hahau a i ʻole TIA, hōʻike kahi ʻōnaehana ʻōnaehana (neurological) i nā pilikia ʻē aʻe.

Loaʻa iā ʻoe i nā hōʻike aʻe:

• Hōʻoia ke kō koko a me nā triglycerides
• Hōʻoia ke kō kō (glucose)
• ʻO ke ultrasound o nā aʻa carotid (carotid duplex ultrasound) e ʻike ai i ke kahe o ke kahe ma waena o ke aʻa carotid

Hiki ke hoʻohana ʻia nā hoʻokolohua kiʻi e nānā nei i nā kīʻaha koko i ka ʻāʻī a me ka lolo.

• Cerebral angiography
• CT angiography
• MR angiography

Nā koho lapaʻau e:

• ʻO nā lāʻau lapaʻau lahilahi e like me aspirin, clopidogrel (Plavix), warfarin (Coumadin), dabigatran (Pradaxa), a i ʻole nā ​​mea ʻē aʻe e hoʻohaʻahaʻa i kou makaʻi no ka hahau
• Hoʻololi nā lāʻau lapaʻau a me nā papaʻai e hoʻohaʻahaʻa i kāu kolesterol a i ʻole ke kahe o ke koko
• ʻAʻohe lāʻau lapaʻau, ʻokoʻa ka nānā ʻana i kāu aʻa carotid i kēlā me kēia makahiki

Loaʻa paha iā ʻoe kekahi mau kaʻina hana e mālama ai i kahi aʻa o ke kaʻa liʻiliʻi a i ʻole wahi ʻia.

• Carotid endarterectomy - Hōʻalo kēia ʻoki i ka plake buildup i nā aʻa carotid.
• Carotid angioplasty a me stenting - Ke wehe nei kēia hana i kahi aʻa i ālai ʻia a waiho i kahi ʻupena uea liʻiliʻi (stent) i ke aʻa e wehe.

Ma muli o ka loaʻa ʻole o nā ʻōuli, ʻaʻole paha ʻoe e ʻike he maʻi carotid artery a hiki i kou loaʻa ʻana i ka hahau a i ʻole TIA.

• ʻO Stroke ke kumu nui o ka make ma United States.
• ʻO kekahi poʻe i loaʻa i ka maʻi hahau e hoʻōla i ka hapa nui a i ʻole o kā lākou hana.
• ʻO kekahi poʻe make i ka hahau ponoʻī a mai i nā pilikia.
• Ma kahi o ka hapalua o ka poʻe i loaʻa ka maʻi hahau i loaʻa i nā pilikia lōʻihi.

ʻO nā pilikia nui o ka maʻi carotid artery:

• Hoʻouka ischemic kuikawa. Hana ʻia kēia i ka wā e ālai iki ai kahi kīʻaha blot i kahi kīʻaha koko i ka lolo. Kuhi ia i nā hōʻailona like me ka hahau. Kū mau nā ʻōuli i kekahi mau minuke i hoʻokahi hola a i ʻole ʻelua, akā ʻaʻole i ʻoi aku ma mua o 24 mau hola. ʻAʻole hiki i kahi TIA ke hōʻino mau loa. ʻO TIA kahi hōʻailona hōʻailona e hiki mai kahi hahau i ka wā e hiki mai ana inā ʻaʻohe mea i hana ʻia e pale aku ai.
• Hahau. Ke āpana a i ʻole paʻa paʻa ke koko i ka lolo. ʻO ka pinepine, hiki kēia i ka wā e ālai ai ke kōkō i kahi kīʻaha koko i ka lolo. Hiki pū kekahi ka hahau ke haki a kulu paha kahi kīʻaha koko. Hiki i nā hahau ke hana i ka lolo lōʻihi a i ʻole ka make.

E hele i ka lumi pilikia a kāhea paha i ka helu kūloko kūloko (e like me 911) ke loaʻa nā hōʻailona. ʻO ka loaʻa koke ʻana iā ʻoe o ka lāʻau, ʻo ka ʻoi aku ka maikaʻi o kou manawa e ola ai. Me ka hahau ʻana, hiki i kēlā me kēia kekona o ka lohi ke hōʻeha i ka lolo.

Eia ka mea hiki iā ʻoe ke hana e pale aku i ka maʻi carotid artery a me ka hahau ʻana.

• E haʻalele i ka puhi pua ʻana.
• E hāhai i ka papaʻai olakino, momona momona me ka nui o nā lau a me nā huaʻai.
• Mai inu ma mua o 1 a 2 mau mea inu ʻona i ka lā.
• Mai hoʻohana i nā lāʻau leʻaleʻa.
• Hoʻomaʻamaʻa ma ka liʻiliʻi 30 mau minuke i ka lā, ka nui o nā lā o ka pule.
• E hōʻoia i kāu kolamu i kēlā me kēia 5 mau makahiki. Inā mālama ʻia ʻoe no ka cholesterol kiʻekiʻe, pono ʻoe e hōʻoia pinepine ʻia.
• E hōʻoia i kou kaomi koko i kēlā me kēia 1 a 2 mau makahiki. Inā loaʻa ʻoe i ke kiʻekiʻe o ke koko, maʻi puʻuwai, diabetes, a i ʻole he maʻi kōkō ʻoe, pono ʻoe e nānā pinepine ʻia. E noi i kāu mea hāʻawi.
• E hāhai i nā ʻōlelo aʻoaʻo a kāu mea hāʻawi inā loaʻa ke kiʻekiʻe o ke koko, diabetes, high cholesterol, a i ʻole nā ​​maʻi puʻuwai.

Carotid stenosis; Stenosis - carotid; Hahau - carotid artery; TIA - aʻa carotid

• Hoʻokomo ʻia ka Angioplasty a me stent - carotid artery - hoʻokuʻu
• ʻOki kino aʻa Carotid - hoʻokuʻu
• Cholesterol - lāʻau lapaʻau
• Lawe iā warfarin (Coumadin)

ʻO Biller J, Ruland S, Schneck MJ. ʻO ka maʻi cerebrovascular Ischemic. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 65.

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. ʻO Catheter Cardiovasc Interv. 2013; 81 (1): E76-E123. PMID: 23281092 www.ncbi.nlm.nih.gov/pubmed/23281092.

Meschia JF, Bushnell C, Boden-Albala B, et al. Nā ʻōkuhi no ka pale mua ʻana i ka hahau: kahi ʻōlelo no ka poʻe ʻoihana ola kino mai ka American Heart Association / American Stroke Association. Hahau. 2014; 45 (12): 3754-3832. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.

Meschia JF, Klaas JP, Brown RD Jr, Brott TG. Ka loiloi a me ka hoʻokele o ka atherosclerotic carotid stenosis. ʻO Mayo Clin Proc. 2017; 92 (7): 1144-1157. PMID: 28688468 www.ncbi.nlm.nih.gov/pubmed/28688468.