Ukubekwa kwe-Angioplasty nokuqina - umthambo we-carotid

Imithambo yegazi eletha igazi ebuchosheni bakho nasebusweni ibizwa ngokuthi yimithambo ye-carotid. Unomthambo we-carotid ohlangothini ngalunye lwentamo yakho.

Ukugeleza kwegazi kulo mthambo kungavimba noma kuvinjwe ngokuphelele izinto ezinamafutha ezibizwa ngokuthi i-plaque. Ukuvinjelwa okuyingxenye kubizwa ngokuthi i-carotid artery stenosis (ukunciphisa). Ukuvinjelwa emthanjeni wakho we-carotid kunganciphisa ukunikezwa kwegazi ebuchosheni bakho. Kwesinye isikhathi ingxenye yoqwembe ingaphuka futhi ivimbe omunye umthambo. Ukushaywa unhlangothi kungenzeka uma ubuchopho bakho bungalitholi igazi elanele.

Izinqubo ezimbili zingasetshenziswa ukwelapha umthambo we-carotid oncishisiwe noma ovinjelwe. Lezi izi:

• Ukuhlinzwa ukususa i-plaque buildup (endarterectomy)
• I-Carotid angioplasty ngokubekwa okunamandla

I-Carotid angioplasty ne-stenting (CAS) yenziwa kusetshenziswa ukusika okuncane kokuhlinzwa.

• Udokotela wakho ohlinzayo uzokwenza ukusika kokuhlinzwa emgodini wakho ngemuva kokusebenzisa umuthi othile wokukindishiza. Uzonikezwa nomuthi wokukuphumuza.
• Udokotela ohlinzayo ubeka ipayipi (ipayipi eliguquguqukayo) ngokusebenzisa ukusikeka emthanjeni. Ihanjiswe ngokucophelela entanyeni yakho ekuvaleni umthambo wakho we-carotid. Ukuhambisa izithombe ze-x-ray (i-fluoroscopy) kusetshenziselwa ukubona umthambo futhi kuqondise i-catheter endaweni efanele.
• Okulandelayo, udokotela ohlinzayo uzohambisa ucingo nge-catheter aye ekuvaleni. Elinye ipayipi elinebhaluni elincane kakhulu ekugcineni lizodudulwa ngale yocingo livalwe. Lapho-ke ibhaluni liyagcwala.
• Ibhaluni licindezela odongeni lwangaphakathi lomthambo wakho. Lokhu kuvula umthambo futhi kuvumela igazi eliningi ukuba ligelezele ebuchosheni bakho. I-stent (i-wire mesh tube) nayo ingafakwa endaweni evinjiwe. I-stent ifakwa ngasikhathi sinye ne-catheter yebhaluni. Iyakhula ngebhaluni. I-stent isele endaweni ukusiza ukugcina umthambo uvulekile.
• Udokotela ohlinzayo ube esesusa ibhaluni.

Ukuhlinzwa kweCarotid (endarterectomy) kuyindlela endala nephumelelayo yokwelapha imithambo emincane noma evinjiwe. Le nqubo iphephe kakhulu.

I-CAS ithuthukise njengenye indlela enhle yokuhlinzwa, lapho kwenziwa ngabasebenza ngokuhlangenwe nakho. Izici ezithile zingavumela ukuthukuthela, njenge:

• Umuntu ugula kakhulu ukuthi angaba ne-carartid endarterectomy.
• Indawo yokuncipha emthanjeni we-carotid yenza ukuhlinza kube nzima.
• Lo muntu wake wahlinzwa intamo noma i-carotid esikhathini esedlule.
• Umuntu ube nemisebe entanyeni.

Izingozi ze-carotid angioplasty nokubekwa kwe-stent, okuncike ezintweni ezifana nobudala, yilezi:

• Ukusabela okwe-allergen kudayi
• Amahlule egazi noma opha endaweni lapho ahlinzwa khona
• Ukulimala kobuchopho
• Ukuvaleka kwangaphakathi kwe-stent (in-stent restenosis)
• Isifo senhliziyo
• Ukwehluleka kwezinso (ingozi enkulu kubantu asebenenkinga yezinso)
• Ukuvinjelwa okwengeziwe komthambo we-carotid ngokuhamba kwesikhathi
• Ukuquleka (lokhu akuvamile)
• Unhlangothi

Umhlinzeki wakho wokunakekelwa kwezempilo uzokwenza ukuhlolwa komzimba futhi enze izivivinyo eziningi zezokwelapha.

Hlala utshela umhlinzeki wakho ukuthi yimiphi imithi oyisebenzisayo, kufaka phakathi izidakamizwa, izithasiselo, noma amakhambi owathengile ngaphandle kwencwadi kadokotela.

Phakathi namasonto ama-2 ngaphambi kwenqubo yakho:

• Izinsuku ngaphambi kokuhlinzwa, kungadingeka uyeke ukuthatha imishanguzo eyenza kube nzima ngegazi lakho ukuminyana. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient) naprosyn (Aleve, Naproxen), kanye neminye imithi efana nale.
• Buza umhlinzeki wakho ukuthi imiphi imithi okufanele uyithathe ngosuku lokuhlinzwa kwakho.
• Uma ubhema, udinga ukuyeka. Cela umhlinzeki wakho akusize uyeke.
• Ngaso sonke isikhathi vumela umhlinzeki wakho azi nganoma yikuphi ukubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma okunye ukugula ongaba nakho ngaphambi kokuhlinzwa kwakho.

UNGAPHUZI lutho ngemuva kwamabili ebusuku ngaphambi kokuhlinzwa kwakho, kufaka phakathi amanzi.

Ngosuku lokuhlinzwa kwakho:

• Thatha imithi otshelwe ukuthi uyiphuze ngophuzo oluncane lwamanzi.
• Uzotshelwa ukuthi ufika nini esibhedlela.

Ngemuva kokuhlinzwa, kungadingeka ukuthi uhlale esibhedlela ubusuku bonke ukuze ubhekelwe noma yiziphi izimpawu zokopha, isifo sohlangothi, noma ukugeleza kwegazi okungahambi kahle ebuchosheni bakho.Ungahle ukwazi ukuya ekhaya ngalo lolo suku uma inqubo yakho yenziwe ekuseni kakhulu futhi wenza kahle. Umhlinzeki wakho uzokhuluma nawe ngokuthi ungazinakekela kanjani ekhaya.

I-Carotid artery angioplasty kanye ne-stenting kungasiza ekwehliseni amathuba okuba nesifo sohlangothi. Kepha kuzodingeka wenze izinguquko kwendlela yokuphila ukusiza ukuvimbela ukwakheka kocwecwe, amahlule egazi, nezinye izinkinga emithanjeni yakho ye-carotid ngokuhamba kwesikhathi. Ungadinga ukushintsha indlela odla ngayo bese uqala uhlelo lokuzivocavoca umzimba uma umhlinzeki wakho ekutshela ukuthi ukuvivinya umzimba kuphephile kuwe.

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

• I-Angina - ukukhishwa
• U-Angina - ukuthi ubuze ini kudokotela wakho
• I-Angina - lapho unezinhlungu esifubeni
• Ukukhishwa kwe-angioplasty ne-stent - inhliziyo
• Izidakamizwa ze-antiplatelet - P2Y12 inhibitors
• I-Aspirin nesifo senhliziyo
• Ibhotela, imajarini namafutha okupheka
• Cholesterol nendlela yokuphila
• I-cholesterol - ukwelashwa kwezidakamizwa
• Ukulawula umfutho wegazi ophakeme
• Kuchazwe amafutha ezokudla
• Amathiphu okudla okusheshayo
• Isifo senhliziyo - ukukhipha
• Isifo senhliziyo - okufanele ubuze udokotela wakho
• Isifo senhliziyo - izici eziyingozi
• Uwafunda kanjani amalebula okudla
• Ukudla okunosawoti omningi
• Ukudla kwaseMedithera
• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile

• I-atherosclerosis yomthambo wangaphakathi we-carotid
• I-Carotid stenosis - i-X-ray yomthambo ofanele
• Abakhiqizi be-cholesterol

U-Aboyans V, uRicco JB, uBartelink MEL, et al. Ukukhetha komhleli - imihlahlandlela ye-2017 ESC yokuxilongwa nokwelashwa kwezifo zemithambo yegazi, ngokubambisana ne-European Society for Vascular Surgery (ESVS). I-Eur J Vasc Endovasc Ukuhlinzwa. I-2018; 55 (3): 305-368. I-PMID: 28851596 pubmed.ncbi.nlm.nih.gov/28851596/.

UBrott TG, uHalperin JL, u-Abbara S, et al. 2011 ASA / ACCF / AHA / AANN / AANS / ACR / ASNR / CNS / SAIP / SCAI / SIR / SNIS / SVM / SVS umhlahlandlela wokuphathwa kweziguli ezine-extracranial carotid ne-vertebral artery disease: isifinyezo esiphezulu: umbiko waseMelika I-College of Cardiology Foundation / American Heart Association Task Force on Guidelines Practice, kanye 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 Ukufanekisa Nokuvimbela, I-Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, kanye ne Society for Vascular Surgery. Ithuthukiswe ngokubambisana ne-American Academy of Neurology kanye ne Society of Cardiovascular Computed Tomography. I-Catheter Cardiovasc Isikhawu. 2013; 81 (1): E76-E123. I-PMID: 23281092 pubmed.ncbi.nlm.nih.gov/23281092/.

UBrott TG, uHoward G, uRoubin GS, et al. Imiphumela yesikhathi eside yokuqothula ne-endarterectomy ye-carotid-artery stenosis. N Engl J Med. 2016; 374 (11): 1021-1031. I-PMID: 26890472 pubmed.ncbi.nlm.nih.gov/26890472/.

IHicks CW, iMalas MB. Isifo se-cerebrovascular: i-carotid artery stenting. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 92.

IKinlay S, iBhatt DL. Ukwelashwa kwesifo semithambo esingavaleki kahle. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 66.

URosenfield K, Matsumura JS, uChaturvedi S, et al. Ukuhlolwa okungahleliwe kwe-stent kuqhathaniswa nokuhlinzwa kwe-asymptomatic carotid stenosis. N Engl J Med. 2016; 374 (11): 1011-1020. I-PMID: 26886419 pubmed.ncbi.nlm.nih.gov/26886419/.