Ua ālai ʻia nā kīʻaha koko i kou lolo? E kamaʻilio kākou e pili ana i ka Carotid Artery Stenting

Ua lohe paha ʻoe i ka hahau? He maʻi koʻikoʻi ia e hoʻoweliweli ai i nā kānaka he nui a hiki ke hoʻololi i ko lākou ola. No laila, ʻo ke kumu nui o kēia hahau ʻana, ʻo ia ka paʻa ʻana o nā kīʻaha koko nui e lawe ana i ka oxygen a me nā meaʻai i ko kākou lolo. Ua like ia me kahi paipu nui i paʻa e lawe ana i ka wai i ka māla. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau koʻikoʻi e wehe hou ana i kēia mau kīʻaha koko i paʻa ʻia, e ʻae ana i ke kahe koko maikaʻi i ka lolo, a e hōʻemi ana i ka pilikia o ka hahau ʻana.

I ka ʻōlelo maʻalahi, he aha ka Carotid Artery Stenting?

E noʻonoʻo he ʻelua mau "aʻa" nui ko kākou ma nā ʻaoʻao ʻelua o ko kākou ʻāʻī e hoʻolako ana i ke koko i ko kākou lolo, ka maka, a me ka ʻāʻī. ʻO kēia nā mea a kākou e kapa nei ma ke ʻano lapaʻau ʻo Carotid Arteries . I ka hala ʻana o ka manawa, hoʻomaka nā waihona momona, ʻoiai ka cholesterol (ka mea a nā kauka e kapa nei he 'plaque'), e kūkulu ma luna o nā paia o kēia mau kīʻaha koko. Ua like ia me ka ʻōpala e kūkulu ana i loko o kahi paipu wai. Mālie, kūkulu kēia mau waihona a emi ke kīʻaha koko, i kekahi manawa e ālai loa ana iā ia. Ua kapa ʻia kēia ʻano he Carotid Artery Stenosis .

ʻO kēia kahi e hoʻokomo ʻia ai kahi paipu metala liʻiliʻi loa e like me ka ʻupena i loko o ka wahi i paʻa ʻia a hoʻonui hou ʻia ke kīʻaha koko i haiki. ʻO kēia ka mea a mākou e kapa nei he stent artery carotid .

Hana ʻia kēia lāʻau lapaʻau e nā loea i hoʻomaʻamaʻa kūikawā ʻia, e like me ka Interventional Cardiologist, Vascular Surgeon, a i ʻole Endovascular Neurosurgeon.

ʻO wai ka mea e pono maoli ai kēia lāʻau lapaʻau?

Ma mua o ke kuhikuhi ʻana o kāu kauka i kēia lāʻau lapaʻau, e hana pinepine lākou i kahi ultrasound scan, CT scan, a i ʻole MRI scan o kou mau kīʻaha koko ʻāʻī e ʻike i ka nui o ko lākou ālai ʻia. Pono pinepine kēia lāʻau lapaʻau no ka poʻe:

• ʻO ka poʻe i hōʻike i nā hōʻailona o ka hahau ʻana a i ʻole ka ministroke a ua hōʻoia ʻia ko lākou carotid artery ua ālai ʻia ma mua o 50% e nā scans.
• No ka poʻe i ʻike ʻole i nā hōʻailona, ​​​​akā ʻoi aku ka paʻa o ko lākou carotid artery ma mua o 70% i nā scan.

Pehea e hoʻomākaukau ai ma mua o ka mālama ʻana?

ʻOiai ʻaʻole kēia he hana nui e like me ke ʻoki kino, pono ia i kekahi hoʻomākaukau. E ʻōlelo paha kāu kauka i kēia mau mea:

• Nā Anticoagulants: E noi ʻia paha ʻoe e hoʻomaka e lawe i ka aspirin a me nā lāʻau like ʻē aʻe (e.g., Clopidogrel, Ticagrelor) ʻekolu a ʻelima mau lā ma mua o kāu lāʻau lapaʻau. He mea nui e lawe i kēia mau lāʻau lapaʻau e like me ka mea a kāu kauka e ʻōlelo ai iā ʻoe, e like me ke kauoha. ʻO ka hana ʻole ʻana pēlā e hoʻopaneʻe ʻia ai kāu lāʻau lapaʻau.
• ʻAi a me ka Mea Inu: E noi ʻia ʻoe e hoʻokē ʻai no kekahi mau hola ma mua o ka mālama ʻana. E hāʻawi aku kāu kauka iā ʻoe i nā ʻōlelo kikoʻī no kēia.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?

ʻElua ala nui e hoʻokomo ai i ka stent i loko o ke kīʻaha koko ma kou ʻāʻī. Na kāu kauka e hoʻoholo i ke ʻano hana kūpono loa iā ʻoe.

I loko o kēia mālama ʻana, e hāʻawi ʻia ʻoe i ka lāʻau lapaʻau e like me ka heparin e pale ai i ke kāpili ʻana o ke koko. ʻO ka maʻamau, hoʻokahi a ʻelua paha hola ka lōʻihi o ke kaʻina hana holoʻokoʻa. Eia nō naʻe, pono ʻoe e noho i ka haukapila no hoʻokahi lā, me ka manawa hoʻomākaukau a me ka nānā ʻana ma hope.

He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?

Ma hope o ke kau pono ʻana o ka stent, e hana ka hui lapaʻau i kēia mau mea:

• Hana ʻia kahi hoʻāʻo e like me ka angiogram e ʻike ai inā lawa ka laulā o ka stent a inā maikaʻi ke kahe ʻana o ke koko.
• Wehe ʻia nā catheters a pau. Noho mau ka stent ma kona wahi.
• E hāʻawi ʻia iā ʻoe ka lāʻau lapaʻau e pono ai e hōʻemi i ka ʻeha āu e ʻike nei.
• E wehewehe ʻia nā hopena o ka lāʻau lapaʻau iā ʻoe a me kou ʻohana.
• Ma hope o kou hoʻi ʻana i ka home, e hāʻawi ʻia ʻoe i nā kuhikuhi no ka lawe ʻana i kāu lāʻau lapaʻau, nā mea e ʻai ai, a pehea e hoʻoikaika kino ai. Ma ke ʻano kūikawā, e haʻi ʻia iā ʻoe e hoʻomau i ka lawe ʻana i ka aspirin a me nā lāʻau lapaʻau ʻē aʻe e hoʻokahe koko.

He aha nā pōmaikaʻi a me nā pilikia o kēia lāʻau lapaʻau?

Aia kekahi mau pono o ka stenting i hoʻohālikelike ʻia me ka carotid endarterectomy kuʻuna.

Nā pono nui

• ʻAʻohe pono no ke ʻoki kino nui: He ʻano hana kēia me ka emi ʻana o ka hopena ma ke kino.
• ʻOki liʻiliʻi a ʻoki ʻole paha: Ma kekahi mau ʻano hana, aia wale nō kahi puncture.
• Hoʻemi ʻia ka pilikia o ka hōʻino ʻana i nā aʻalolo ma ka ʻāʻī.
• Ua hoʻemi ʻia ka ʻeha ma hope o ka mālama ʻana.

Nā pilikia hiki ke loaʻa (Nā pilikia)

E like me nā lāʻau lapaʻau āpau, aia kekahi mau pilikia. Akā, ʻaʻole kēia e hana i nā kānaka a pau.

• Ua emi ('Hypotension') a ua piʻi paha ('Hypertension') ke koko.
• Ka lohi o ka puʻuwai (Bradycardia).
• Ke kahe ʻana o ke koko mai kahi i hoʻokomo ʻia ai ka ʻōmole.
• Ke kāpili ʻana o ke koko.
• Hahau: Aia kahi pilikia liʻiliʻi o ka hahau ʻana mai kahi ʻaʻa koko liʻiliʻi e hele ana i ka lolo i ka wā a ma hope paha o ka mālama ʻana.
• Ke kahe nei ke koko i loko o ka lolo.

Hiki ke loli kēia pilikia ma muli o kou mau makahiki, inā he mau maʻi ʻē aʻe kou, a me ka nui o ke ālai ʻana i loko o ke kīʻaha koko. No laila, e kamaʻilio me kāu kauka e pili ana i kēia a nīnau i kāu mau nīnau.

He aha kāu e hana ai e loaʻa ai nā hopena maikaʻi loa?

ʻAʻole e ho'ōla loa ʻia ke kūlana i hoʻopilikia ai i nā kīʻaha koko (atherosclerosis) ma hope o ke kau ʻia ʻana o ka stent. No laila, he mea nui loa ia e hoʻololi i kou nohona e pale aku ai i nā pilikia like ʻole i ka wā e hiki mai ana.

• E pale loa i ka puhipaka: ʻAʻole wale nā ​​​​cigarettes, bidis, a me nā cigars, akā ʻo ka "vaping" pū kekahi e pono e hoʻōki ʻia.
• E lawe pono i kāu mau lāʻau lapaʻau: E lawe i nā lāʻau lapaʻau i kauoha ʻia e kāu kauka i ka manawa kūpono a me ka nui kūpono.
• E mālama i ke kaumaha olakino.
• Hoʻoikaika kino mau: ʻO ka hele wāwae ʻana no 30 mau minuke i ka lā he mea maikaʻi ia.
• E hahai i kahi papaʻai olakino no ka puʻuwai: e ʻai iki i ka ʻaila, ka paʻakai, a me ke kō, a e hoʻonui i nā huaʻai a me nā mea kanu.
• E kāohi i nā maʻi ʻē aʻe:Inā loaʻa iā ʻoe ka maʻi diabetes, ke koko kiʻekiʻe, a i ʻole ka cholesterol, e mālama pono iā lākou (e.g., e mālama i ke koko ma lalo o 130, ka cholesterol LDL ma lalo o 70, a me ka HbA1c ma lalo o 7).
• E hele no nā hoʻokolohua hahai: E hōʻoia e hele i ke kauka i nā lā āna e haʻi aku ai iā ʻoe e hele mai e nānā i ke kūlana o ka stent.

He aha ka manawa ho'ōla a i ka manawa hea e pono ai iaʻu ke kāhea aku i ke kauka?

Pono ʻoe e hoʻomaha iki no ka pule mua ma hope o ka hoʻi ʻana i ka home.

• Mai hāpai i nā mea kaumaha (ʻoi aku ma mua o 10 kg).
• Mai hoʻoluʻu i kahi i hoʻokomo ʻia i loko o ka wai (e.g., ʻauʻau, ʻauʻau) no hoʻokahi pule. ʻAʻole pilikia ka ʻauʻau ʻana.
• Inā ʻoe e piʻi ana i nā alapiʻi, e piʻi mālie iki aʻe iā lākou.

Nā kūlana e pono ai ka nānā koke ʻana:

Eia kekahi, inā e hoʻomau ke kahe ʻana o ke koko i kahi o ka ʻōmole, pehu, a i ʻole ka pus, e kāhea koke aku i kāu kauka.