Ua ʻike anei ʻoe i ke kūlana i kapa ʻia ʻo 'Endoleak' e kū mai ana ma hope o ka mālama ʻana i ka aneurysm?

Ua lohe paha ʻoe i kahi Aneurysm, kahi kūlana e nāwaliwali ai ka paia o ka aorta a i ʻole kahi kīʻaha koko nui i loko o ke kino a puʻupuʻu e like me ka pōpō? Malia paha ua loaʻa iā ʻoe kekahi, a ua mālama nā kauka iā ia ma ke komo ʻana i kahi ʻōmole liʻiliʻi i kapa ʻia ʻo Stent Graft, ʻo ia hoʻi kahi hana i kapa ʻia ʻo Endovascular, ʻo ia hoʻi me ka ʻole o ka hana ʻana i kahi ʻoki nui. E noʻonoʻo e like me ka liki ʻana i loko o kahi paipu wai kahiko. No laila, hoʻokomo nā kauka i kahi ʻōmole ʻē aʻe i loko o ka liki e hoʻoikaika iā ia. Eia naʻe, i kekahi manawa ma hope o kēlā lāʻau lapaʻau, hoʻomaka kahi koko liʻiliʻi e liki mai loko mai o Stent Graft, i loko o ka ʻeke kahi i loaʻa ai ka Aneurysm. ʻO ia ka mea a mākou e kapa nei ʻo Endoleak i ka lāʻau lapaʻau. I kēia lā, e kamaʻilio mākou me nā kikoʻī hou aku e pili ana i ke ʻano maoli o kēia, no ke aha e hana ai, he mea weliweli paha, pehea e ʻike ai, a me nā lāʻau lapaʻau.

He aha maoli ka manaʻo o 'Endoleak'?

I ka ʻōlelo maʻalahi, ʻo ke ʻano o ka Endoleak ma hope o ka mālama ʻia ʻana a me ka hoʻopaʻa ʻia ʻana o ka Aneurysm, hoʻomaka hou ke koko e kahe i loko o ka ʻeke Aneurysm kahiko. I kēia manawa, e nānā, ʻo ka maʻamau i ka wā e mālama ʻia ai kahi Aneurysm, kahe wale kou koko ma o ka ʻōmole Stent Graft i hoʻokomo hou ʻia. Ua like kēia Stent Graft me ke kākoʻo no ka paia o ke kīʻaha koko i nāwaliwali. No laila, ʻaʻole kahe ke koko i ka ʻāpana i hōʻino ʻia a puʻupuʻu o ke kīʻaha koko, ʻo ia hoʻi, ka Aneurysm Sac. A laila e pau ka Aneurysm i ka nui a me ka pahū ʻana. Pono e maikaʻi inā ʻaʻohe kahe koko.

Eia nō naʻe, inā no kekahi kumu e kahe ana ke koko ma waho o ka 'Stent Graft' a i loko o ka 'Aneurysm Sac', ua kapa ʻia kēlā ʻo 'Endoleak'. Nui nā kumu e hiki ai kēia 'Endoleak'. ʻO kekahi o lākou ma muli o nā pilikia me ka 'Graft' ponoʻī, a ʻo kekahi o lākou ma muli paha o nā kīʻaha koko liʻiliʻi ʻē aʻe e hoʻomaka ana mai ka 'Aneurysm Sac'. Ua like ia me ka wai e kahe ana mai kekahi mau wahi ma hope o ka wehe ʻia ʻana o kahi hale.

Inā loaʻa kahi Endoleak i loko o 30 mau lā o kēia lāʻau Endovascular, kapa mākou ia he early endoaks . ʻO nā mea e ulu ana ma hope o 30 mau lā ua kapa ʻia ʻo secondary endoaks a i ʻole late endoaks .

Pehea ka maʻamau o ka 'Endoleak'?

I kēia manawa, ke noʻonoʻo nei paha ʻoe inā he mea kēia ʻEndoleak i loaʻa i nā kānaka a pau a i ʻole he mea ia e kakaʻikahi ana. ʻOiaʻiʻo, hiki i kēia kūlana ʻEndoleak ke loaʻa ma kahi o 1 o 4 mau kānaka e hana ʻia ana i ka Endovascular Aneurysm Repair (kapa mākou iā ia ʻo EVAR no ka pōkole - he lāʻau lapaʻau kēia no Aneurysm ma ka paia ʻōpū) a i ʻole Thoracic Endovascular Aneurysm Repair (TEVAR) no Aneurysm ma ka umauma . No laila, ʻaʻole ia he mea i lohe ʻole ʻia. ʻO ia ke kumu he mea nui loa ka makaʻala i kēia.

He mea weliweli anei ka Endoleak?

E hopohopo iki paha kēia iā ʻoe. "Auē, makaʻu wau e kahe hou ana ke koko, ʻeā?" Akā, ʻaʻole weliweli nā endoleaks āpau . ʻAʻole hana kekahi mau endoleaks i kekahi mea ʻino a hoʻomaikaʻi iā lākou iho. E like me ka ho'ōla ʻana o kahi ʻeha liʻiliʻi iā ia iho. I ia mau hihia, hiki i kāu kauka ke hoʻoholo e nānā wale i kou kūlana. ʻO ia hoʻi ka hoʻomau ʻana i ka hana ʻana i nā hoʻokolohua a ʻike i ka mea e hana ʻia.

Eia nō naʻe, ʻoi aku ka koʻikoʻi o kekahi mau ʻano ʻEndoleak. I mea e pale ai i ka hiki ke nui hou a pahū ka ʻAneurysm, pono e mālama koke ʻia. No ka mea, inā pahū ka ʻAneurysm, hiki ke hoʻoweliweli i ke ola. No laila, inā he mea weliweli kēia a ʻaʻole paha, pili ia i ke ʻano o ka ʻEndoleak a me kona wahi. Hoʻoholo nā kauka ma muli o kēia mau mea āpau.

He aha nā ʻano o ka 'Endoleak' i loaʻa?

ʻElima mau ʻano ʻEndoleak i ʻike ʻia i kēia manawa. He ʻokoʻa ke kumu o kēlā me kēia ʻano. E like me kēlā me kēia maʻi he kumu ponoʻī kona. Me ka hoʻomohala ʻana o ka ʻenehana 'Stent Graft' hou, ua emi iki kekahi mau ʻano ʻEndoleak, he mea maikaʻi ia.

ʻO kēia mau mea , ʻo ka ʻano 2 Endoleak ka mea maʻamau . Eia nō naʻe , ʻoi aku ka weliweli o nā ʻano 1 a me 3 endoleaks , no ka mea, hoʻonui lākou i ka pilikia o ka pahū ʻana o ka ʻAneurysm (ʻūpā). E nānā pono kākou i kēia mau ʻano.

ʻAno 1 Endoleak

Hana ʻia kēia ke hoʻopili pono ʻole ʻia ka stent graft i ka paia o ke kīʻaha koko, ʻo ia hoʻi, ʻaʻole i hoʻopaʻa pono ʻia. E noʻonoʻo, inā he hakahaka liʻiliʻi ma waena o ka uhi a me ka paia, e kahe ka wai mai laila mai, a e kahe ke koko mai ka ʻaoʻao luna (proximal) a i ʻole ka ʻaoʻao haʻahaʻa (distal) o ka stent graft a komo i loko o ka ʻeke aneurysm. He maʻi koʻikoʻi ka endoleak ʻano 1, no laila pono pinepine ka mālama koke ʻana. ʻOi aku ka nui o kēia mau mea e haki ai ka aneurysm ma mua o nā ʻano ʻē aʻe. Inā ʻike nā kauka i kēia, e hana koke lākou.

ʻAno 2 Endoleak

ʻO kēia ke ʻano endoleak maʻamau . ʻOi aku ka maʻamau ma hope o EVAR ma mua o TEVAR no nā aneurysms ʻōpū. Hiki mai kēia leak ke kahe ke kahe ke koko mai kou aorta a i ʻole ke aʻa stent i loko o ka ʻeke aneurysm ma o nā kīʻaha koko liʻiliʻi (nā kīʻaha lālā a i ʻole nā ​​​​kīʻaha collateral). E noʻonoʻo he mau lālā liʻiliʻi (lālā) kou aorta. I kēia manawa, inā paha e kau mākou i kahi stent graft hou e pani i ka lua i loko o ka aorta, hiki nō ke kahe kekahi koko mai kēlā mau lālā. ʻO ia ke ʻano o ka Type 2 endoleak.

ʻO ka hapa nui o ka manawa, ʻike ʻia nā ʻano Endoleaks ʻano 2 i loko o 30 mau lā o kāu mālama ʻana iā Endovascular. Eia nō naʻe, hiki iā lākou ke hana ma hope aku, i ʻike ʻia ʻo "late endoleaks." Ma kahi o 40% o nā ʻano Endoleaks ʻano 2 i ʻike ʻia ma hope o 30 mau lā. Ma kahi o 8% i ʻike ʻia ma hope o hoʻokahi makahiki o ka mālama ʻana.

Akā, ʻaʻole ʻino loa ka hapa nui o nā ʻEndoleak ʻAno 2. Hoʻōla lākou iā lākou iho ma hope o ʻeono mahina me ka ʻole o ka lāʻau lapaʻau. No ka mea, pani ʻia kēlā mau kīʻaha koko liʻiliʻi ma o lākou iho. ʻOiai inā ʻaʻole lākou e hoʻōla, inā paʻa ka ʻAneurysm Sac a ʻaʻole e nui aʻe, hiki i ke kauka ke nānā pono iā ia. Akā i kekahi manawa, i ka hala ʻana o ka manawa, hiki i kēia ʻAno 2 Endoleak ke hoʻololi i ka ʻAneurysm Sac a lilo i ʻEndoleak ʻoi aku ka weliweli e like me ke ʻano 1 a i ʻole ke ʻano 3. Inā hana ʻia kēlā, pono ka lāʻau lapaʻau. Inā ʻoi aku ka nui o ka ʻAneurysm ma mua o 5 millimeters (5mm), pono paha ʻoe i ka lāʻau lapaʻau. Inā waiho ʻole ʻia ka ʻAneurysm, aia kahi manawa e pahū ai ka ʻAneurysm.

ʻAno 3 Endoleak

Loaʻa kahi Endoleak ʻAno 3 i ka wā e kaʻawale ai nā ʻāpana modular e pili ana o kāu stent graft, a i ʻole inā haehae a haehae paha ka lole o ka graft. Ua like kēia me kahi paipu e kaʻawale ana ma ke hono, a i ʻole he lua i loko o ka paipu ponoʻī. E like me ka Endoleak ʻAno 1, aia kahi pilikia o ka pahū ʻana o ka aneurysm no ka mea ke kahe pololei nei ke koko i loko o ka ʻeke aneurysm ma lalo o ke kaomi. No laila, he mea nui ka mālama koke ʻana. Eia nō naʻe, me ka holomua o ka hoʻolālā ʻana i nā hāmeʻa, he kakaikahi nā Endoleaks ʻAno 3.

ʻAno 4 Endoleak

Hana ʻia kēia i ka wā e kahe ai ke koko ma o nā lua liʻiliʻi i loko o ke kāpili stent (ka porosity o ka mea kāpili). ʻIke pinepine ʻia kēia i ka wā mua o ka mālama ʻana, akā hoʻopau pinepine ia ma kāna iho. He pilikia kakaikahi loa kēia o ke kāpili, a ʻoi aku ka liʻiliʻi o nā kāpili i hoʻohana ʻia i kēia lā.

ʻAno 5 Endoleak

Ua kapa ʻia hoʻi ʻo Endotension ʻAno 5. He mea kupanaha iki kēia. ʻO ka mea e hana ʻia ma kēia hihia, ʻoiai ʻaʻohe hōʻailona o Endoleak ma nā hoʻokolohua Imaging, ke hoʻomau nei ka ulu ʻana o ka Aneurysm Sac. ʻOiai ʻaʻole maopopo ke kumu pololei o kēia, ua manaʻo ʻia aia paha he ka hoʻoili ʻana o ke kaomi ma o ka Stent Graft, ʻoiai ʻaʻohe kahe koko i ʻike ʻia. He kūlana kēia e pono e nānā ʻia.

He aha nā hōʻailona o ka 'Endoleak'?

ʻO kēia ka pilikia i loaʻa i nā poʻe he nui. ʻAʻohe mau hōʻailona āu e manaʻo ai e ʻike inā he endoleak kou. ʻAʻole paha ʻoe e ʻike i kekahi ʻokoʻa. ʻIke ʻia kahi endoleak e nā hoʻokolohua kiʻi i hana ʻia i ka lā o kāu mālama ʻana a ma o nā hoʻokolohua hahai i hana ʻia ma hope.ʻO ia ke kumu he mea nui loa ka hele ʻana i kēlā mau hoʻokolohua hahai. ʻO ka hele ʻana i nā hoʻokolohua pololei i nā lā a ke kauka i ʻōlelo ai ʻo ia wale nō ke ala e ʻike koke ai i kahi mea e like me kēia.

Eia nō naʻe, inā e nui aʻe ka aneurysm a pahū (nā haki ʻana o ka aneurysm) ma muli o ka endoleak (ʻoi aku ka ʻano weliweli), he pilikia olakino ia . Inā hana ʻia kēia, hiki ke ʻike ʻia nā hōʻailona aʻe. Inā hana ʻia kēia , pono ʻoe e kāhea i ka 911 a i ʻole e hele koke i ka haukapila kokoke loa :

• Ua anu ke kino a ua hou ('ʻIli pulu, ʻili hou').
• ʻĀʻī, he manaʻo e milo ana i loko o ke poʻo.
• Ka mae ʻana, ka nalowale ʻana o ka ʻike.
• Ke wikiwiki nei ka puʻuwai ('Fast heartbeat').
• Ka luaʻi a me ka luaʻi.
• Paʻakikī ka hanu ʻana, me he mea lā e ʻūlū ana ʻoe (pōkole ka hanu).
• ʻEha koke a nui hoʻi ma kou ʻōpū, ke kua i lalo a i ʻole nā ​​​​wāwae.
• ʻEha ʻoi a haehae koke i kou umauma a i ʻole ke kua.

Inā ʻike ʻia kēia mau hōʻailona, ​​mai hoʻokaʻulua.

Pehea ʻoe e loaʻa ai kahi Endoleak?

E like me ka mea i ʻōlelo ʻia ma mua, ʻike ʻia kahi endoleak ma o nā hoʻokolohua kiʻi. Hana ʻia kēia mau hoʻokolohua i ka wā a ma hope o kāu hoʻoponopono ʻana i ka aneurysm endovascular. ʻO ka hapa nui o ka manawa, ʻike ʻia ia i ka lā hoʻokahi a i ʻole i loko o 30 mau lā o ke kaʻina hana. Eia nō naʻe, hiki ke hana i kekahi manawa a hiki i 12 mau mahina a ʻoi aku paha. ʻO ia ke kumu he mea nui e mālama i kāu mau manawa hoʻopaʻa āpau. E like me ka lawelawe ʻana i kahi kaʻa, he mea kēia e pono e mālama mau ʻia.

Nā hoʻāʻo e ʻike ai i ka Endoleak

ʻO nā hoʻokolohua nui i hoʻohana ʻia no ka ʻike ʻana i ka 'Endoleak' i ka wā a ma hope o ka mālama ʻana:

• ʻO ke kiʻi ʻana o ka Computed Tomography (CT) scans: Lawe kēia i nā kiʻi ʻokiʻoki o loko o ke kino. Hiki ke ʻike maopopo ʻia ka Stent Graft, Aneurysm Sac, a me nā kahe koko.
• ʻO Doppler Ultrasound: Hoʻohana kēia i nā nalu kani e nānā i ke kahe o ke koko. Hiki iā ia ke ʻike inā he endoleak a pehea ke kahe ʻana o ke koko.
• Angiogram: Ma kēia, ua hoʻokomo ʻia kahi wai kūikawā (contrast dye) i loko o nā kīʻaha koko a lawe ʻia nā kiʻi X-ray. Hiki ke ʻike maopopo ʻia ke kahe ʻana o ke koko a me nā leaka.

Hiki i kēia mau hoʻokolohua ke kōkua i ka hoʻoholo ʻana inā ua holomua kāu lāʻau lapaʻau, inā ua hoʻokomo ʻia ke kāpili stent, a inā he leakage a puni ka stent.

Pono ʻoe e hana i kēia mau hoʻokolohua 'kiʻi' no nā mahina a i ʻole nā ​​​​makahiki ma hope o ka mālama ʻana. E haʻi aku kāu kauka iā ʻoe e pili ana i kēia mau hoʻokolohua a me ka pinepine o kou hana ʻana iā lākou. Eia nō naʻe, he mea nui kēia mau hoʻokolohua e hopu koke i kekahi 'endoleak' e ulu aʻe ma hope ('secondary endoaks') a mālama iā ia inā pono.

He aha nā lāʻau lapaʻau no ka ʻEndoleak?

E mālama kāu hui lapaʻau i kāu Endoleak e like me kāu mau pono pilikino. He ʻokoʻa ke ʻano o ka mālama ʻana iā Endoleak no kēlā me kēia kanaka. E pili kēia i ke ʻano o kou kino (no ka laʻana, ka lōʻihi o ka ʻāʻī o kou aneurysm, kahi o nā kīʻaha koko, a pēlā aku), ke ʻano o Endoleak, a me kona wahi. Ma keʻano laulā, aia ʻekolu mau koho nui no ka mālama ʻana iā Endoleak: ka nānā ʻana, ka mālama ʻana i ka endovascular, a/a i ʻole ke ʻoki kino hāmama.

Nānā ʻana

Inā loaʻa iā ʻoe kahi ʻano endoleak ʻaʻole koʻikoʻi loa, e like me ka endoleak Type 2, hiki i kāu kauka ke paipai i kahi ala "kiaʻi makaʻala" e ʻike ai inā e ho'ōla ia iā ia iho. Hiki ke hana kēia inā e paʻa nā kīʻaha koko e pili ana (clot off), e hoʻōki ana i ke kahe koko i ka ʻeke aneurysm. Eia nō naʻe, inā e hoʻonui ka endoleak i ka ʻeke aneurysm (ʻo ia hoʻi, ʻoi aku ka nui ma mua o 5 mm), pono ʻoe i ka lāʻau lapaʻau e pale aku ai i ka haki ʻana.

Lapaʻau Endovascular

ʻO kēia ka lāʻau lapaʻau maʻamau no kahi aneurysm endovascular. Hiki i kāu kauka ʻoki endovascular ke hana i kahi hoʻoponopono aneurysm endovascular me ka hoʻohana ʻana i nā ʻano hana minimally invasive. Hiki i kēia mau mea ke komo pū me:

• Ke ālai nei i nā kīʻaha koko lālā e hoʻolako ana i ke koko i ka aneurysm. ʻO ia hoʻi, ua hoʻokomo ʻia kahi mea kūikawā (embolizing agent) i loko o nā kīʻaha koko liʻiliʻi e hoʻoulu ai i ka Type 2 Endoleak a ua pani ʻia lākou.
• ʻO ke Stent Graft kahi hana e pili ana i ke kau ʻana i nā ʻāpana Stent hou aʻe (cuffs a i ʻole extenders) ma ʻō aku o ka leaka, e hoʻolōʻihi ana i ka ʻāpana o kou aʻa nui (Aorta) kahi i kau ʻia ai ka Stent. Hana pinepine ʻia kēia no ka Type 1 Endoleak.
• Ke hele pololei nei i ka ʻeke aneurysm a me ke sila ʻana i ka ʻeke aneurysm me ka hoʻohana ʻana i nā mea e like me ke kāpili.

ʻAe kēia mau ʻano hana i ka mālama ʻana me ka ʻole o kahi ʻoki nui, ma o kahi lua liʻiliʻi.

ʻOki Hana (ʻOki Hana Hāmama)

Inā ʻaʻole hiki a hāʻule paha nā lāʻau lapaʻau endovascular, ʻo ke ʻoki hāmama ka hopena hope loa. Pili kēia i ka hana ʻana i kahi ʻoki nui, ke komo ʻana i loko o ka aneurysm, a me ka hoʻoponopono ʻana i ka stent graft a i ʻole ke kau ʻana i kahi mea hou. He mea kākaʻikahi loa kēia, no ka mea, ʻoi aku ka holomua o nā ʻano hana endovascular i kēia manawa.

He aha kāu e manaʻo ai inā loaʻa iā ʻoe kahi 'endoleak'?

ʻO ka hapa nui o ka manawa, ʻaʻole pono ka lāʻau lapaʻau no ka Endoleak, ʻoiai ke ʻano 2. ʻOiai inā pono ka lāʻau lapaʻau, he nui nā koho minimally invasive e pono ai nā ʻoki liʻiliʻi. Ua hōʻike kēia mau lāʻau lapaʻau Endovascular i nā helu holomua kiʻekiʻe loa. Eia kekahi, ke hoʻomau nei nā ʻenehana hou i ka hoʻomaikaʻi ʻana i ka hoʻohana ʻana i nā grafts stent e hōʻemi ana i ka pilikia o Endoleak.

Inā loaʻa iā ʻoe kahi endoleak, mai hopohopo. E wehewehe kāu kauka i kāu mau koho lapaʻau iā ʻoe. ʻO ka mea nui loa, ʻo ia ka hoʻomau ʻana i nā hoʻokolohua hahai ma hope o ka ho'ōla ʻana o ka endoleak.He mea nui loa ka ʻike a me ka mālama ʻana i nā pilikia e hiki mai ana me kāu stent graft i ka hikiwawe loa, e like me ka mālama ʻana i kahi kaʻa.

Āhea wau e ʻike ai i kaʻu kauka?

E mālama pono i nā manawa hoʻopaʻa a pau ma hope o kāu lāʻau lapaʻau EVAR a i ʻole TEVAR. E haʻi aku kāu kauka iā ʻoe i ka pinepine o kou pono ʻana i nā hoʻokolohua kiʻi. ʻO ka maʻamau, e kokoke loa lākou i ka wā mua, akā e lilo paha i mea pinepine i ka hala ʻana o ka manawa. E hahai pono i kēlā mau kuhikuhi.

Eia kekahi, inā ʻike ʻoe i kekahi o nā hōʻailona ulia pōpilikia e hele mai me kahi aneurysm i haki, e like me ka mea i ʻōlelo ʻia ma mua, e hele koke i ka haukapila me ka kali ʻole.

Nā nīnau e nīnau aku ai i kāu kauka

Ma hope o kāu hana EVAR a i ʻole TEVAR, e nīnau i kāu kauka e pili ana i nā pilikia o nā pilikia. Eia kekahi, e kamaʻilio e pili ana i nā hoʻokolohua hahai a me nā hoʻokolohua kiʻi e manaʻo ai. Hiki iā ʻoe ke nīnau i nā nīnau e like me:

• He aha nā hopena ʻaoʻao (nā pilikia) o kēia lāʻau lapaʻau? He aha koʻu pilikia o ka loaʻa ʻana o ka endoleak?
• ʻEhia pinepine e pono ai iaʻu ke hele mai no ka nānā ʻana? He aha ke ʻano o nā hoʻokolohua (e like me ka CT scan, ultrasound) e pono ai iaʻu?
• He aha nā koho lapaʻau e loaʻa iaʻu inā loaʻa iaʻu kahi 'endoleak'?
• He aha nā hoʻololi o ke ʻano o ka nohona e hiki iaʻu ke hana e kōkua ai i ke olakino o koʻu puʻuwai a mālama i kaʻu stent graft i ke kūlana maikaʻi? (e.g., ka haʻalele ʻana i ka puhipaka, ka hoʻoikaika kino, ka ʻai ʻana)

He mea nui loa ka nīnau ʻana i nā nīnau e like me kēia e hoʻomaopopo maikaʻi ai i kou kūlana.

He aha ka leka e hiki iā kākou ke lawe i ka home mai kēia moʻolelo?

He pilikia hiki ke mālama ʻia ʻo Endoleak i hiki ke hana ma hope o ka hoʻoponopono ʻana i ka aneurysm endovascular. ʻAʻole paha ʻoe e pono i kekahi lāʻau lapaʻau. Eia nō naʻe, inā hana ʻoe, e kamaʻilio kāu kauka me ʻoe e pili ana i nā koho lapaʻau kūpono iā ʻoe.

He mea maʻamau ka loaʻa ʻana o nā pilikia e like me kēia ma hope o kahi kaʻina hana hoʻopakele ola, e like me ka mālama ʻana i kahi aneurysm. Eia nō naʻe, ʻoi aku ka nui o nā pono o ke kaʻina hana ma mua o nā pilikia . No laila, mai hopohopo inā ʻike ʻoe e pili ana i kahi endoleak.

ʻO ka mea nui loa, ʻo ia ke hele i nā manawa hoʻopaʻa a ke kauka e hāʻawi ai iā ʻoe a loaʻa nā hoʻokolohua āna e ʻōlelo ai. Ma kēlā ala, hiki ke ʻike koke ʻia a mālama ʻia kekahi mau pilikia.

Inā manaʻo ʻoe ua luhi a kaumaha hoʻi, he mea maʻamau ia. Nui ka poʻe e hele nei i ka mea like me ʻoe. E kamaʻilio me kāu kauka a me kou ʻohana e pili ana i nā ala e hoʻokele ai i ke kaumaha e hele mai me ka hoʻōla ʻana. ʻAʻole ʻoe hoʻokahi.

ʻEndoleak , Aneurysm, Stent Graft, EVAR, TEVAR, Ke kahe ʻana o ke koko, Aneurysm, Stent Graft, Maʻi Puʻuwai