He aʻa paʻa anei kou i loko o kou ʻāʻī? E aʻo kākou e pili ana i ka Carotid Artery Stenting, ka mea e pale ai i ka hahau ʻana.

Ua haʻi aku anei kāu kauka iā ʻoe ua paʻa kekahi kīʻaha koko nui ma kou ʻāʻī a ua pilikia ʻoe i ka loaʻa ʻana o ka hahau? He mea maʻamau ke manaʻo iki i ka makaʻu ke lohe ʻoe i kahi mea e like me kēia. Akā, mai hopohopo. I kēia lā, ua holomua loa ka lāʻau lapaʻau. Aia nā lāʻau lapaʻau kūpono loa e ho'ōla i kēlā mau paʻa a hōʻemi i ka pilikia o ka hahau ʻana. I kēia lā, ke kamaʻilio nei mākou e pili ana i kekahi lāʻau lapaʻau kūpono loa a ʻaʻole paʻakikī loa: ke kau ʻana i kahi stent carotid.

I ka ʻōlelo maʻalahi, he aha ka carotid stenting?

ʻAe, e hoʻomaka kākou ma ka wehewehe maʻalahi ʻana. Loaʻa iā kākou ʻelua mau kīʻaha koko nui 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 aku nei ʻo Carotid Arteries . I ka hala ʻana o ka manawa, hoʻomaka nā mea e like me nā momona a me ka cholesterol mai nā meaʻai a kākou e ʻai ai e kūkulu ma nā paia o kēia mau kīʻaha koko. Kāhea mākou i kēia 'plaque' . Ua like ia me ka ʻōpala e kūkulu ana i loko o kahi paipu wai.

Hoʻokumu kēia palaki a hoʻohaiki i ke alahele i loko o ke aʻa, i kekahi manawa e ālai loa ana iā ia. Ua kapa ʻia kēia ʻano he stenosis aʻa carotid . Ke hana ʻia kēia, ua emi ke kahe o ke koko i ka lolo, ʻo ia kekahi kumu nui o ka hahau ʻana.

No laila, ʻo ka carotid stenting kahi lāʻau lapaʻau e wehe hou ai i kahi aʻa i paʻa. Maanei, hoʻokomo ke kauka i kahi stent , kahi paipu metala liʻiliʻi i hana ʻia e like me ka ʻupena, i loko o kahi i paʻa a hoʻopiha iā ia mai loko mai. A laila hoʻonui hou ʻia ke aʻa i paʻa, e hoʻihoʻi ana i ke kahe koko. Hoʻokomo mau ʻia kēia stent i loko o ke aʻa. Ua like ia me kahi kākoʻo e kūʻē i ka paia e kokoke ana e hiolo, e kōkua ana i ke aʻa e hoʻōki hou i ka haʻahaʻa.

ʻO wai ka mea e pono ai kēia lāʻau lapaʻau?

ʻO ka maʻamau, e ʻōlelo ke kauka i kēia lāʻau lapaʻau ma hope o ka nānā ʻana i kou aʻa carotid no nā mea i pāpā ʻia. Hiki i kēia ke pili i nā hoʻokolohua e like me ka carotid ultrasound , CT scan , a i ʻole MRI . Pono pinepine ʻia kēia lāʻau lapaʻau no:

• No ka poʻe i loaʻa i nā hōʻailona o ka ministroke a i ʻole ka hahau a ʻoi aku ka paʻa o ko lākou aʻa ma mua o 50%.
• No ka poʻe i ʻike ʻole i nā hōʻailona akā ua ālai ʻia ko lākou aʻa ma mua o 70%.

Na kāu kauka e hoʻoholo inā kūpono kēia lāʻau lapaʻau no kou kūlana, a inā paha he kūpono kahi ʻoki ʻokoʻa (Carotid Endarterectomy).

Ke hoʻomākaukau ʻana a me ka hana ʻana i ka lāʻau lapaʻau

E hoʻomaka paha kāu kauka iā ʻoe i kekahi mau lāʻau hoʻokahe koko i kekahi mau lā ma mua o kāu kaʻina hana, e like me ka aspirin a me ka clopidogrel .

Pehea e hana ʻia ai ka lāʻau lapaʻau?

Hana ʻia kēia e ke kauka loea i loaʻa i ke aʻo kūikawā no kēia kumu. E hāʻawi ʻia ʻoe i ka lāʻau lapaʻau e pale aku i ka ʻeha i ka wā o ka mālama ʻana. Aia kekahi mau ʻano hana nui no ke kau ʻana i ka stent.

Na kāu kauka e hoʻoholo i ke ʻano hana kūpono loa iā ʻoe. ʻO ke kaʻina hana holoʻokoʻa e lawe ma kahi o hoʻokahi a ʻelua paha hola. Eia nō naʻe, pono ʻoe e noho i ka haukapila no hoʻokahi lā, no ka mea, e lawe ʻia kekahi mau hola hou aʻe no ka hoʻomākaukau ʻana a me ka nānā ʻana ma hope.

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

Ma hope o ka lāʻau lapaʻau, e hana ke kauka i kahi angiogram e nānā inā e hana pono ana ka stent a inā ua hoʻi ke kahe o ke koko i ka maʻamau. A laila, e wehe ʻia ke catheter a me nā mea hana ʻē aʻe a e hāʻawi ʻia iā ʻoe nā lāʻau ʻeha a me nā ʻōlelo aʻoaʻo ʻē aʻe āu e pono ai.

ʻO ka mea nui loa, pono ʻoe e hoʻomau i ka lawe ʻana i kāu lāʻau hoʻokahe koko (e.g., Aspirin, Clopidogrel) ʻoiai ma hope o kou hoʻi ʻana i ka home. Mai hoʻōki i ka lawe ʻana i kēia lāʻau me ke kamaʻilio ʻole ʻana me kāu kauka. Pono ʻoe e lawe i kēia lāʻau no kekahi mau mahina.

Ka manawa ho'ōla ma hope o ka ho'i 'ana i ka home

• Mai hāpai i kekahi mea kaumaha ma mua o 20 paona (e like me kahi bākeke wai) no hoʻokahi pule.
• Mai hoʻoluʻu i ka wahi ʻoki/ʻoki i loko o ka wai (ʻaʻohe ʻauʻau, loko ʻauʻau) no hoʻokahi pule ma hope o ka mālama ʻana. Ua maikaʻi ka ʻauʻau ʻana.
• E akahele iki aʻe i ka piʻi ʻana i ke alapiʻi.
• E hoʻomaʻamaʻa mālie i kāu hana maʻamau i loko o hoʻokahi pule.

Nā pono, nā pilikia, a me ka holomua lōʻihi o ka mālama ʻana

ʻOi aku ka liʻiliʻi o ka invasiveness o kēia lāʻau lapaʻau ma mua o ke ʻoki kino hāmama kuʻuna, nona kekahi mau pono. ʻO nā mea nui, ʻo ia nā ʻoki liʻiliʻi, ka emi ʻana o ka pilikia o ka hōʻino ʻana i nā aʻalolo ma ka ʻāʻī, a me ka emi ʻana o ka ʻeha ma hope o ka lāʻau lapaʻau.

ʻO nā pilikia e hiki mai ana ke kahe koko, ke koko haʻahaʻa/kiʻekiʻe (Hypotension/Hypertension), ka lohi o ka puʻuwai (Bradycardia), nā ʻūpā koko, a me ka hahau pinepine ʻole. E wehewehe kikoʻī kāu kauka i kēia mau pilikia iā ʻoe.

ʻO ka mea nui, ʻaʻole e ho'ōla kēia lāʻau i ka maʻi kumu (atherosclerosis). Hoʻopau wale ia i ka mea paʻa. No laila, he mea nui e hoʻololi i kou nohona e pale aku ai i ke aʻa mai ka paʻa hou ʻana.

• E hoʻōki loa i ka puhipaka a me ka vaping.
• E lawe i ka lāʻau lapaʻau i kauoha ʻia e ke kauka i ka manawa kūpono.
• E mālama i ke kaumaha olakino.
• E hoʻoikaika kino i nā manawa a pau.
• E hoʻomau i ka ʻai olakino no ka puʻuwai e haʻahaʻa ana i ka ʻaila, ka paʻakai, a me ke kō, a kiʻekiʻe i nā huaʻai a me nā mea kanu.
• E mālama pono i kou koko kiʻekiʻe, ka cholesterol (LDL ma lalo o 70), a me ka maʻi diabetes (HbA1c ma lalo o 7).
• E ʻike i ke kauka i ka manawa i hoʻonohonoho ʻia a e nānā ʻia ʻoe.

Pilikia! He aha kāu e hana ai inā loaʻa iā ʻoe kēia mau hōʻailona?

He mea nui loa kēia. Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, e kelepona koke aku i ka 1990 Ambulance Service me ka hoʻokaʻulua ʻole a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.

• Nā hōʻailona o ka hahau ʻana: ke kūlou ʻana ma kekahi ʻaoʻao o ka maka, ka paʻakikī i ka ʻōlelo ʻana a i ʻole ka hoʻomaopopo ʻana i nā huaʻōlelo, ka nalowale o ka manaʻo a i ʻole ka mae ʻana o ka lima a i ʻole ka wāwae.
• Inā he nui ke kahe koko a i ʻole ka pehu ʻana ma kahi i hoʻokomo ʻia ai ka stent (ʻūhā, lima, a ʻāʻī paha).

I kekahi manawa hiki ke lilo ke aʻa i mea haiki ma muli o ka ulu hou ʻana o nā ʻiʻo ma kahi i mālama ʻia. Kāhea mākou i kēia he 'restenosis' . ʻO ia ke kumu he mea nui ka loaʻa ʻana o nā ultrasounds maʻamau.