Ua lohe paha ʻoe e hiki i ke kīʻaha koko koʻikoʻi loa i loko o ko kākou kino ke pehu e like me ka pōpō? He kūlana weliweli maoli kēia. Akā, mai hopohopo, me ka holomua o ka ʻepekema lapaʻau, hiki ke mālama ʻia kēia ma ke ʻano maʻalahi loa me ka ʻole o ka hana ʻana i kahi ʻoki nui. I kēia lā e kamaʻilio mākou e pili ana i ia mea. Ua kapa ʻia kēia ʻano hana ʻo EVAR.
I ka ʻōlelo maʻalahi, he aha ʻo EVAR?
ʻO ke ʻano piha o EVAR ʻo ia ka Endovascular Aneurysm Repair . He hana ʻoki kino minimally invasive kēia. Hoʻohana ʻia ia e mālama i nā aneurysms, a i ʻole e like me kā mākou e kapa nei iā lākou ma nā huaʻōlelo lapaʻau , aneurysms , ma ka aorta, ke kīʻaha koko nui i loko o ko mākou ʻōpū.
E noʻonoʻo ʻoe ʻo ke kīʻaha koko nui loa i loko o ko kākou kino ʻo ia ka aorta. Maanei kahi e hoʻolaha ʻia ai ke koko mai ka puʻuwai a i ke kino holoʻokoʻa. I kekahi manawa, ke nāwaliwali kahi wahi ma ka paia o kēia kīʻaha koko, ʻo ke kaomi o ke koko ke kumu o kēlā wahi nāwaliwali e pehu i waho e like me ka pōpō. ʻO ia ka mea a mākou e kapa nei he aneurysm.
I ka mālama ʻana iā EVAR, ʻelua wale nō lua liʻiliʻi loa i hana ʻia ma nā ʻaoʻao ʻelua o ke aʻa koko, a hoʻokomo ʻia nā mea hana kūikawā ma o lākou e hoʻoponopono i ke kīʻaha koko pehu mai loko mai.
No ke aha mākou e pono ai i kēia lāʻau EVAR?
ʻO ka pahuhopu nui o kēia lāʻau lapaʻau, ʻo ia ka pale ʻana i ka pahū ʻana o ke kīʻaha koko e like me ka pōpō (aneurysm), no ka mea, inā pahū ia, he hoʻoweliweli nui ia i ke ola.
Inā pahū kahi kīʻaha koko, hoʻomaka ke kahe koko nui i loko o ke kino, hiki ke hoʻoweliweli i ke ola i loko o nā minuke.
I ka mālama ʻana iā EVAR, hoʻokomo nā kauka i kahi paipu kūikawā (stent graft) i hana ʻia me ka lole a me ka ʻupena metala i loko o ke kīʻaha koko pehu. Ma hope o ke komo ʻana o kēia paipu, kahe ke koko ma o kēia paipu hou. A laila, ʻaʻole e paʻi ke kaomi o ke koko i ka paia nāwaliwali o ke kīʻaha koko pehu. No laila, ua aneane pau loa ka pilikia o ka pahū ʻana.
No wai kēia lāʻau lapaʻau EVAR i kūpono loa?
Inā he aneurysm aortic kou, kūpono paha kēia lāʻau lapaʻau iā ʻoe. Eia naʻe, ʻaʻole mālama ʻia nā aneurysms āpau i ka manawa like. Hiki i kāu kauka ke noʻonoʻo i ka EVAR i nā hihia aʻe:
- Inā nui kou aneurysm a inā he liʻiliʻi paha akā ke ulu wikiwiki nei .
- Inā ʻaʻole hiki i kou kino ke ʻae i ke ʻoki hāmama me kahi ʻoki nui.
- Inā olakino nā kīʻaha koko ma luna a ma lalo o ka aneurysm .
Aia kekahi mau ʻano hana ʻē aʻe e like me EVAR? (FEVAR a me TEVAR)
ʻAe, hoʻohana ʻia kēia ʻano lapaʻau me nā ʻano like ʻole ma muli o ka wahi o ka aneurysm.
He aha ka FEVAR?
E noʻonoʻo i ko kākou aorta e like me ke kumu lāʻau. Mai kēia kumu, māhele nā lālā (nā aʻa liʻiliʻi) e lawe ana i ke koko i nā ʻōpū i loko o ko kākou ʻōpū (e like me nā puʻupaʻa a me nā ʻōpū). I kekahi manawa, hoʻokumu ʻia kahi aneurysm kokoke i kahi e māhele ai kekahi o kēia mau lālā. I kēlā hihia, he paʻakikī ke hana i kahi EVAR maʻamau.
No ia mau hihia paʻakikī, hoʻohana ʻia kahi ʻano hana kūikawā i kapa ʻia ʻo FEVAR (Fenestrated Endovascular Aneurysm Repair) . ʻO ke kāpili stent i hoʻohana ʻia ma ʻaneʻi he mau lua liʻiliʻi (fenestrations) i hana ʻia e kūpono i kahi e māhele ai nā lālā. Ma o kēlā mau lua, hiki ke kau ʻia nā stent liʻiliʻi no kēlā mau lālā. E like me kahi paipu i hoʻolālā ʻia e kūpono i ke kumu a me nā lālā o kahi lāʻau.
ʻO ka ʻokoʻa ma waena o EVAR a me TEVAR
He mea maʻalahi loa kēia.
- Hana ʻia ʻo EVAR no nā aneurysms i loko o ka ʻōpū (ʻōpū) .
- Hana ʻia ʻo TEVAR (Thoracic Endovascular Aneurysm Repair) no nā aneurysms i loko o ka lua o ka umauma (thorax) .
ʻO ka maʻamau, he kūleʻa loa ʻo TEVAR no nā aneurysms i loko o nā aʻa nui e holo ana i lalo ma ka umauma, kahi mamao iki mai ka puʻuwai. Eia nō naʻe, no nā aneurysms kokoke loa i ka puʻuwai, pono pinepine ʻia ke ʻoki hāmama.
| Nā pono nui o ka mālama ʻana iā EVAR | |
|---|---|
| Pōmaikaʻi | Wehewehena |
| Ua hoʻemi ʻia ka nui o nā lā ma ka haukapila. | Hiki iā ʻoe ke hoʻi koke i ka home ma mua o ke ʻoki kino hāmama. |
| Ka emi ʻana o ke kahe koko | ʻOiai ʻaʻohe ʻoki nui, ua liʻiliʻi loa ka nui o ke koko e puka ana mai ke kino aku. |
| Emi ka ʻeha i ka wā e ho'ōla ai | ʻOiai ʻaʻohe ʻeha nui, ua liʻiliʻi ka ʻeha a me ke kaumaha. |
| E hoʻoikaika koke | Hiki iā ʻoe ke hoʻi koke i nā hana maʻamau. |
| Ua emi ka manawa o ke ʻoki kino. | Hiki ke hoʻopau ʻia ke ʻoki kino i ka manawa pōkole ma mua o kahi ʻoki kino hāmama. |
Aia kekahi mau pilikia me kēia lāʻau lapaʻau?
He lāʻau palekana loa a holomua loa ʻo EVAR, akā e like me nā ʻoki kino āpau, aia kahi manawa liʻiliʻi o nā pilikia.
- Nā ʻAʻa Koko: I kekahi manawa hiki ke hana ʻia nā ʻaʻa koko i loko o nā aʻa hohonu o nā wāwae. Kāhea mākou i kēia ʻo Deep Vein Thrombosis (DVT) .
- Endoleak: ʻOiai ma hope o ke kau ʻia ʻana o ka stent, kahe iki ke koko ma waena o ka stent a me ka paia o ke kīʻaha koko a hui pū me ka aneurysm.
- Maʻi: Maʻi ma kahi o ka ʻeha.
- Ka hāʻule ʻana o ka puʻupaʻa
- Maʻi hohola
- Ke kahe koko nui
He haʻahaʻa loa kēia mau pilikia. E wehewehe kāu kauka i kēia mau mea āpau iā ʻoe ma mua o ke ʻoki ʻana.
Pehea e hana ʻia ai ke ʻoki kino?
ʻAe, e nānā kākou i nā ʻanuʻu e pili ana i kēia ʻoki kino.
1. ʻO ka mea mua, e hāʻawi ʻia ʻoe i ka anesthesia e hoʻomoe iā ʻoe a i ʻole e hoʻomoe māmā iā ʻoe. No laila, ʻaʻole ʻoe e ʻeha.
2. A laila, e komo ke kauka i ka aneurysm i loko o kou ʻōpū ma o nā aʻa femoral i loko o kou ʻūhā.
3. Me ka hoʻohana ʻana i ʻelua nila lahilahi loa, ua hoʻokomo ʻia kahi catheter , he ʻōmole lahilahi a palupalu, i loko o kēia mau aʻa ʻelua. Ua pelu ʻia ka stent graft a mākou i ʻōlelo ai ma mua i loko o kēia catheter.
4. ʻOiai e nānā ana i kahi pale kūikawā e like me ke kiʻi X-ray, alakaʻi ke kauka i kēia catheter ma ke aʻa koko a hiki i kahi o ka aneurysm.
5. Ke kau ʻia ma kahi kūpono loa, e hoʻonui ʻia ka ʻōmole stent i loko o ke catheter. A laila e hoʻonui ʻia i loko o ke kīʻaha koko, e hana ana i kahi ala hou a ikaika no ke kahe ʻana o ke koko.
6. Hoʻopaʻa paʻa ʻia kēia ʻōmole stent i ka paia o ke kīʻaha koko, e pale ana i ke koko mai ke komo ʻana i loko o ka aneurysm.
7. Ma hope o ka pau ʻana o ke kaʻina hana, wehe pono ʻia ke catheter. He liʻiliʻi loa nā puka i loko, ʻaʻole pono nā humuhumu. Hoʻopili ʻia kahi plaster liʻiliʻi i ka ʻeha e kōkua i kona ho'ōla ʻana.
Pehea ka manawa ho'ōla ma hope o ke ʻoki kino?
ʻO ka maʻamau, he mau lā a hiki i hoʻokahi mahina e hoʻōla piha ai ʻoe.
- Pono ʻoe e noho i ka haukapila no ʻelua a ʻekolu paha lā.
- Hiki iā ʻoe ke hoʻomaka e ʻai a inu koke ma hope o ka anesthesia.
- Hiki iā ʻoe ke ala aʻe mai kahi moe a hele wāwae me ke kōkua o nā kahu maʻi.
- E luhi iki paha ʻoe a ʻeha hoʻi no kekahi mau lā ma hope o kou hoʻi ʻana i ka home. Pono ʻoe e hoʻohana pono i nā lāʻau hoʻomaha ʻeha i hāʻawi ʻia iā ʻoe.
- E pale i ka hoʻokele kaʻa a hiki i kou lawe ʻana i nā lāʻau hoʻomaha ʻeha.
- Hiki i ka hapanui o nā kānaka ke hoʻi i ka hana i loko o hoʻokahi mahina.
- Pono ʻoe e pale i ka hāpai ʻana i nā mea kaumaha no 4 a 6 mau pule.
| Inā loaʻa iā ʻoe kēia mau hōʻailona, e ʻike koke i kāu kauka. | |
|---|---|
| ʻAno | Wehewehena |
| Pehu wāwae, ʻeha | He mau hōʻailona paha kēia o ka deep vein thrombosis (DVT) i nā wāwae. Hoʻokomo pū kēia me ka ʻili anuanu ma nā wāwae. |
| Pōʻino a i ʻole ka nawaliwali | He hōʻailona paha ia o kekahi pilikia i loko. |
| ʻEha kua, umauma, a ʻōpū paha | He pilikia paha kēia me ka stent a i ʻole ka aneurysm. |
| Nā palpitations o ka puʻuwai | Ka puʻuwai wikiwiki ʻē aʻe (Heart Palpitations). |
| ʻUlaʻula a ʻeha paha ma ka ʻāpana groin | He hōʻailona paha ia o ka maʻi ma kahi i hana ʻia ai ke ʻoki. |
Leka Lawe-Home
- He koho ʻoi aku ka maikaʻi o EVAR, he minimally invasive ma mua o ke ʻoki kino hāmama kuʻuna.
- Ma hope o kēia lāʻau lapaʻau, e ola koke ʻoe a hiki iā ʻoe ke hoʻi koke i ka home.
- ʻOiai ma hope o kou ho'ōla ʻana, pono ʻoe e mālama i kou puʻuwai a me nā kīʻaha koko. Hiki i nā mea e like me ka hoʻoikaika kino a me ka hōʻemi ʻana i ka paʻakai i kāu meaʻai ke kōkua i ka pale ʻana i nā pilikia e hiki mai ana.
- ʻO ka mea nui loa, ʻo ia ke ʻike hou i ke kauka i ka manawa i hoʻonohonoho ʻia no nā hoʻokolohua hahai. Ma kēlā ala, hiki iā ʻoe ke nānā inā e hana pono ana ka stent āu i hoʻokomo ai a inā he mau pilikia ʻē aʻe.
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