Ua ālai ʻia nā kīʻaha koko i kou ʻāʻī? E aʻo kākou e pili ana i ke ʻoki ʻana o TCAR (Transcarotid Artery Revascularization)

Ua haʻi aku anei kāu kauka iā ʻoe ua paʻa kahi kīʻaha koko nui ma kou ʻāʻī a ua pilikia nui ʻoe i ka loaʻa ʻana o ka hahau? He mea maʻamau no kekahi ke makaʻu iki i ka lohe ʻana i kekahi mea e like me ia. "Pono anei au e hana ʻoki kino? He mea nui anei ia?" Nui nā nīnau e hiki mai ana i ka noʻonoʻo. Akā, mai hopohopo, no ka mea, ua holomua ka ʻepekema lapaʻau, aia i kēia manawa nā lāʻau lapaʻau palekana loa, maʻalahi a maikaʻi hoʻi no ia mau kūlana. I kēia lā, e kamaʻilio mākou e pili ana i kekahi o nā lāʻau lapaʻau hou loa a holomua loa, ʻo TCAR.

I ka ʻōlelo maʻalahi, he aha ka TCAR?

ʻO Transcarotid Artery Revascularization ka inoa piha o TCAR. ʻAe, kani iki kēia inoa, ʻeā? E mālama kākou i ka maʻalahi.

Aia ʻelua mau kīʻaha koko nui ma nā ʻaoʻao ʻelua o ko kākou ʻāʻī e lawe ana i ke koko i ka lolo. Kāhea mākou i kēia mau mea ʻo nā aʻa carotid . Ua like kēia me nā paipu nui ʻelua e lawe mai ana i ka wai i ko mākou hale. I ka hala ʻana o ka manawa, hōʻiliʻili nā mea e like me ka momona a me ka cholesterol mai nā meaʻai a mākou e ʻai ai i loko o kēia mau kīʻaha koko, e like me ka ʻōpala e hōʻiliʻili ana i loko o kahi paipu wai. Ua kapa ʻia kēia he 'plaque' ma nā ʻōlelo lapaʻau.

I ka ulu mālie ʻana o kēia papa 'plaque', emi iho ka hakahaka i loko o ke kīʻaha koko, a ālai ʻia ke kahe ʻana o ke koko. ʻO ka mea weliweli loa, inā haki kahi ʻāpana liʻiliʻi o kēia papa 'plaque' a hele i ka lolo me ke koko, hiki iā ia ke ālai i kahi kīʻaha koko i loko o ka lolo a hana i kahi hahau .

No laila, ʻo ka wehe hou ʻana i kēia kīʻaha koko i ālai ʻia a me ka hoʻihoʻi ʻana i ke kahe koko ka mea a mākou e kapa nei ʻo 'revascularization.' Aia kekahi mau ala nui e hana ai i kēia.

1. Carotid Endarterectomy (CEA): He hana ʻoki kino kuʻuna kēia. Ma kēia, hana ʻia kahi ʻoki liʻiliʻi ma ka ʻāʻī, wehe ʻia ke kīʻaha koko, wehe ʻia ka papa o ka 'plaque' i loko, a humuhumu hou ʻia ke kīʻaha koko.

2. Carotid Angioplasty a me Stenting (CAS): Hoʻokomo ʻia kahi ʻōmole lahilahi loa ma o kahi kīʻaha koko ma ka ʻūhā a i ʻole ka lima a alakaʻi ʻia i ke kīʻaha koko i paʻa i ka ʻāʻī. A laila hoʻonui ʻia ka wahi i paʻa me kahi mea e like me ka balloon, a hoʻokomo ʻia kahi 'stent' , kahi ʻōmole mesh liʻiliʻi, e pale aku iā ia mai ka pani hou ʻana.

3. TCAR (Transcarotid Artery Revascularization): He ʻano hana palekana a hou hoʻi ʻo TCAR e hoʻohui i ka maikaʻi loa o nā ʻano hana ʻelua. Pili ia i ka hana ʻana i kahi ʻoki liʻiliʻi loa ma luna pono o ka iwi ʻāʻī ma ka ʻāʻī a me ke kau ʻana i kahi stent pololei i loko o ke kīʻaha koko i paʻa.

No wai kēia ʻoki kino TCAR i kūpono loa?

Ua hoʻolauna mua ʻia ke ʻano TCAR i ka makahiki 2015 no nā poʻe maʻi i pilikia nui no ke ʻoki kino hāmama kuʻuna (CEA). ʻO ia hoʻi:

• No ka poʻe ʻelemakule .
• No ka poʻe me ka maʻi puʻuwai a i ʻole ka maʻi akemāmā .
• No ka poʻe i loaʻa ka ʻiʻo ʻeha mai ke ʻoki ʻāʻī ma mua a i ʻole ka radiation therapy.
• Inā ua ālai ʻia ke kīʻaha koko ma kahi e paʻakikī ai ke ʻoki ʻana, e like me ma lalo o ka iwi ʻauwae.

Akā i kēia manawa, ua holomua loa kēia ʻano hana a mai ka makahiki 2022, ua ʻōlelo ʻia ka mālama ʻana iā TCAR no nā poʻe maʻi i ke olakino maʻamau, ʻo ia hoʻi, ka poʻe me ka ʻole o nā kumu pilikia kūikawā. A hiki i kēia manawa, ua hana ʻia ma mua o 20,000 mau ʻoki TCAR ma ʻAmelika Hui Pū ʻIa wale nō.

Pehea ʻoe e hoʻomākaukau ai ma mua o ke ʻoki kino?

Inā hoʻoholo kāu kauka e hana i ke ʻoki TCAR ma luna ou, pono ʻo ia e hana i kekahi mau hoʻokolohua ma mua.

• Nā hoʻāʻo koko: E ʻike e pili ana i kou olakino laulā a me kou hiki ke kāpili koko.
• ʻO ke kiʻi ultrasound o ke aʻa Carotid: E ʻike i ka nui o ke kīʻaha koko i ālai ʻia.
• CT Angiogram: E kiʻi i kahi kiʻi ʻekolu-dimensional maopopo o nā kīʻaha koko i loko o ka ʻāʻī a me ka lolo.

Eia kekahi, e hoʻomaka ke kauka iā ʻoe ma kekahi mau lāʻau lapaʻau e hoʻomākaukau iā ʻoe no ke ʻoki ʻana.

• Nā lāʻau lapaʻau ʻano statin e hoʻohaʻahaʻa i ka cholesterol.
• Nā lāʻau lapaʻau e like me ka aspirin a me ka clopidogrel e pale ai i ke kāpili ʻana o ke koko.

E aʻo ʻia ʻoe ʻaʻole e ʻai a inu paha i kekahi mea ma hope o ke aumoe o ka pō ma mua o ke ʻoki ʻana.

Pehea e hana ʻia ai ke ʻoki kino: kēlā me kēia ʻanuʻu

E lōʻihi ana kēia hana ʻoki kino ma kahi o hoʻokahi hola a me ka hapa. E nānā koke kākou i nā mea e hana ʻia ana ma ka lumi ʻoki kino.

1. Anesthesia: I mea e pale ai iā ʻoe mai ka ʻeha ʻana, e hoʻomānoʻino ʻia ka ʻāpana a puni kou ʻāʻī (anesthesia kūloko) a i ʻole e hoʻomānoʻino loa ʻia ʻoe (anesthesia laulā) .

2. ʻOki liʻiliʻi: Hana ʻia kahi ʻoki liʻiliʻi loa ma ka ʻāʻī, ma luna pono o ka iwi ʻāʻī, ma kahi o 1-1.5 ʻīniha.

3. Hoʻohuli ʻana i ke kahe: ʻO kēia ka hana koʻikoʻi a palekana loa i ke kaʻina hana TCAR.

• Hoʻokomo ʻia kahi ʻōmole lahilahi i loko o kahi aʻa koko ma ka ʻāʻī (femoral vein).
• Hoʻokomo ʻia kekahi paipu i loko o ke aʻa carotid i ālai ʻia ma o ka ʻoki ʻāʻī.
• I kēia manawa, ua hoʻopili ʻia kēia mau ʻōmole ʻelua i kahi mīkini me kahi kānana kūikawā. Ma hope o kēlā, ua hoʻōki ʻia ke kahe koko i ka lolo no kekahi manawa, a hele mai ke koko mai ke aʻa ma ka ʻāʻī ma o kēlā ʻōmole, ua hoʻomaʻemaʻe ʻia e ke kānana, a hoʻi i ke kino ma o ka ʻōmole ma ka ʻūhā.
• I kēia manawa, ʻo ke koko e pono ai kou lolo e hele mai ana mai ke aʻa carotid ma kēlā ʻaoʻao o kou ʻāʻī a me nā aʻa vertebral ma ke kua o kou lolo.Loaʻa ia me ke keakea ʻole.

4. Ke wehe ʻana i ka mea ālai: Hoʻohana ʻia kahi uea lahilahi e hele ma ʻō aku o ka mea ālai a hoʻonui i ka ʻāpana me kahi pōpō liʻiliʻi.

5. Ke kau ʻana o ka stent: A laila, hoʻokomo ʻia kahi ʻōmole metala liʻiliʻi, i kapa ʻia he stent , i loko o ka mea i pani ʻia. Mālama kēia i ke kīʻaha koko e hāmama a paʻa i ka plaque i ka paia.

6. Pau: A laila wehe ʻia nā ʻōmole āpau, a humuhumu ʻia ka lua liʻiliʻi i loko o ke kīʻaha koko a me ka ʻoki ma ka ʻāʻī.

He aha ka mea e hana ʻia ma hope o ke ʻoki kino?

Ma hope o ke ʻoki kino TCAR, pono ʻoe e noho ma ka haukapila no hoʻokahi pō . E nānā mau nā kauka a me nā kahu maʻi i kou olakino. ʻOiai he ʻoki kino maʻalahi loa kēia, wikiwiki loa ka hoʻōla ʻana.

He aha nā pilikia a me nā pilikia?

E like me nā lāʻau lapaʻau a pau, hiki i ka TCAR ke lawe mai i kekahi mau pilikia liʻiliʻi loa. Eia nō naʻe, ua haʻahaʻa loa ka likelika o kēia mau mea.

• Ke kahe ʻana o ke koko a i ʻole ka pehu ʻana mai kahi i ʻoki ʻia.
• Ka maʻi o ka ʻoki ʻia.
• Ka pōʻino iki i ke aʻalolo ma ka ʻāʻī.
• Hahau.
• Maʻi hohola.

E wehewehe hou aku kāu kauka i kēia mau pilikia iā ʻoe. E hoʻomanaʻo he mau hana kūikawā e hana ʻia e hōʻemi i kēia mau pilikia i ka wā o ke kaʻina hana TCAR.

Ke ho'ōla hou nei a me ke ola ʻana me kahi stent

He hana wikiwiki loa ʻo TCAR no ka mea ʻaʻohe ʻoki nui.

• E pale i ka hāpai ʻana i nā mea kaumaha no hoʻokahi a ʻelua paha pule.
• E nānā i ka ʻoki ma kou ʻāʻī i kēlā me kēia lā e hōʻoia i ka maʻemaʻe a ʻaʻohe hōʻailona o ka maʻi.
• E nīnau i kāu kauka i ka wā hiki iā ʻoe ke hoʻi i kāu hana a me nā hana ʻē aʻe o kēlā me kēia lā.

Ma hope o ke kau ʻia ʻana o ka stent, na ʻoe ia e pale aku i ke kīʻaha koko mai ka pani hou ʻia ʻana. No ka hana ʻana i kēia, pono ʻoe e hana i kēia mau mea.

• Inā ʻoe e puhipaka ana, e hoʻōki koke.
• E hoʻoikaika kino i nā manawa a pau.
• E hoʻomau i ka ʻai olakino me ka haʻahaʻa i nā momona saturated.
• E lawe i ka lāʻau hoʻokahe koko a me ka lāʻau hoʻohaʻahaʻa cholesterol i kauoha ʻia e kāu kauka i ka manawa kūpono.

Āhea wau e ʻike ai i ke kauka?

Inā ʻike ʻoe i nā hōʻailona o ka maʻi ma kahi i ʻoki ʻia, e kāhea koke aku i kāu kauka.

• kuni
• Inā ʻoe e anu
• Inā he ʻulaʻula a me ka pehu a puni ka ʻoki ʻana
• Inā puka mai kahi mea e like me ka wai mai ka ʻoki

Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe. E kūkākūkā i nā nīnau, nā hopohopo, a i ʻole nā ​​kānalua āu e loaʻa ai me ia. ʻO kāna pahuhopu ka hāʻawi iā ʻoe i ka lāʻau lapaʻau kūpono a palekana loa.