Yu tink se korona at kin blok bak afta dɛn dɔn put stent? (In-Stent Rɛstɛnɔsis) .

Yu ɔ pɔsin we yu sabi dɔn put stent na korona at? Afta dis kayn tritmɛnt, bɔku tɛm wi kin tink se naw di prɔblɛm dɔn sɔlv ɔl, di korona at nɔ go blok igen. Bɔt sɔntɛnde, smɔl blɔk ɔ narrowing kin apin bak na di sem ples usay dɛn put di stent, dat na di sem pat pan di at we dɛn bin trit. Na dat dɔktɔ dɛn kin kɔl ‘In-Stent Restenosis’. Pan ɔl we di nem kin tan lɛk se i kɔmplikt smɔl, fɔ tru, i rili simpul. Lɛ wi tɔk bɔt dis ditayli, insay Sinhala we yu kin ɔndastand.

Fɔs, lɛ wi ɔndastand dɛn wɔd ya, nɔto so?

Bifo wi tɔk bɔt ‘in-stent restenosis’, lɛ wi ɔndastand di minin fɔ sɔm wɔd dɛn. Dɔn i go klia to yu.

Wetin na ‘Stenosis’?

Fɔ tɔk am simpul wan, ‘stenosis’ na we wan blɔd vesel na wi bɔdi de smɔl ɔ smɔl. Imajin se as tɛm de go, dɔti ɛn rɔst kin kam insay wata paip, ɛn dis kin mek wata nɔ ebul fɔ flɔ.

So, wetin na korona at sik (CAD)?

Wi at nid blɔd bak fɔ mek i wok. di men at dεm we de gi am dεn kכl dεm di korona at dεm. CAD na we fεt dεposit dεm we dεn kכl plek de bil insay wan כ mכr pan di korona at dεm, we de mek di at dεm sכmtεm sכmtεm. Dɛn kin kɔl dis bak atherosclerosis. Sɔm pipul dɛn kin kɔl am bak "hardening of the arteries." Dis fat we de bɔku kin apin smɔl smɔl, ɛn i nɔ kin sho ɛni sayn fɔs. Bɔt if dɛn nɔ trit am, i kin mek i gɛt siriɔs sik lɛk at atak ɛn at pwɛl.

Wetin na ‘Angioplasty’ ɛn ‘Stent’?

Wan pan di men tritmɛnt dɛm we dɔktɔ dɛn kin yuz fɔ opin di korona at we dɔn blok bikɔs ɔf CAD na in dɛn kɔl angioplasty. Sɔntɛnde dɛn kin kɔl am bak pɔrkyutan korona intavɛnshɔn (PCI). insay dis, dεn kin put wan tכn tכb (kateta) tru wan sכmכl ol na di skin insay di at we dεn blכk. Wan smɔl tin we tan lɛk balɔ we de na di ɛnd pan di tiub kin ful-ɔp, ɛn dis kin mek di at we dɔn blok big. afta dat, fכ mek di at nכ kכlכp bak εn fכ mek di bכdi fכ fכlכ fayn fayn wan, dεn de put wan sכmכl mεsh tכb – na dat stent de fכ – insay di at we dεn wayd. Dɔn, blɔd kin flɔ fayn fayn wan bak.

Okay, naw wetin na dis ‘In-Stent Restenosis’?

Naw yu ɔndastand wetin mek ɛn aw dɛn kin put stent. afta dεn put stent εn di bכdi fכ fכlכ bak na di korona at, sכmtεm di at kin bigin fכ sכmtεm bak rayt usay dεn bin put di stent, dat na insay di stent. Na dat mek wi kin kɔl am ‘In-Stent Restenosis’. 'Re' min "agayn", ɛn 'stenosis' min "narrowing". So, dis min se "narrowing bak insay di stent".

Aw dis sik kin kɔmɔn?

Naw yu kin de wɔnda if dis na sɔntin we difrɛn fɔ ɔlman we gɛt stent.Nɔ, dis nɔ kin apin to ɔlman we gɛt stent. כltu, fכ tכk roughly, lεk 1 pan 4 pipul dεm we gεt stent gεt sכm chans fכ divεlכp dis kכndyushכn we dεn kכl `In-Stent Restenosis`. Dis kin apin insay tri to siks mɔnt afta dɛn dɔn put di stent.

Impɔtant: If yu gɛt balyɔn angioplasty we yu nɔ put stent, di risk fɔ mek yu gɛt restenosis kin ivin bɔku. Na lɛk 4 pan ɛvri 10 pipul dɛn go gɛt dɛn at we dɛn go blok bak.

Wetin mek ‘in-stent restenosis’ kin apin?

Na rili intrestin kwɛstyɔn. afta dεn put stent, wi bכdi de tray fכ "hεl" am. dat min se, nyu layεr fכ sεl dεm (wan ``nyu layn``) de gro oba di stent, we de mek di insay pat pan di vein sכft bak. Dis na rili gud tin, bikɔs da tɛm de di blɔd kin flɔ izi wan we i nɔ kin klɔt.

כltu, sכmtεm, כnda dis nyu layεr fכ sεl dεm, we de rawnd di stent, sכm sכm tu mכ ch ska tisu de gro. We dis ska tisu gro tumɔs, di insay layn na di at kin tik, ɛn dis kin mek di blɔd flɔ bak smɔl. Dis na di men tin we kin mek pɔsin gɛt `In-Stent Restenosis`.

Mɛmba se dis kin apin insay tri to siks mɔnt afta dɛn dɔn put stent. afta dat, di risk fכ ska tisu fכ fכm εn blכk di vein de rili sכm.

Udat de pan ay risk fɔ gɛt ‘in-stent restenosis’?

Pan ɔl we ɛnibɔdi we gɛt stent we dɛn put fɔ CAD kin gɛt dis sik we dɛn kɔl `In-Stent Restenosis`, sɔm pipul dɛn kin gɛt smɔl smɔl risk. Lɛ wi tek wan luk pan udat dɛn bi:

• Fɔ pipul dɛn we gɛt ay kɔlɔstrel na dɛn blɔd. (Na dis kin mek bɔku pipul dɛn gɛt at sik!)
• Fɔ di wan dɛn we gɛt sik na dɛn kidni .
• Fɔ di wan dɛn we de smok. (Dis na sɔntin we yu fɔ stɔp fɔ du!)
• Fɔ di wan dɛn we nɔ gɛt dayabitis we dɛn nɔ kin kɔntrol fayn .
• Fɔ di wan dɛn we gɛt ay blɔd prɛshɔn we dɛn nɔ kin kɔntrol (haypa prɛshɔn).

If yu gɛt tin dɛn lɛk dis, i rili impɔtant fɔ tɔk to yu dɔktɔ ɛn kɔntrol dɛn.

Wetin na di sayn dɛm fɔ ‘in-stent restenosis’?

Bɔrku tɛm, pipul dɛm wae gɛt `In-Stent Restenosis` nɔr kin sho ɛni ɔda sayn. Na dat mek i rili impɔtant fɔ go to yu dɔktɔ ɔltɛm ɛn du di tɛst dɛn we yu nid afta dɛn dɔn put stent.

Bɔt sɔm pipul dɛn kin gɛt sɔm sayn dɛn. If dɛn du dat, bɔku tɛm di sayn dɛm kin tan lɛk di wan dɛm wae gɛt CAD we bin dɔn de bifo. Dɛn tin ya na:

• Fɔ fil pen, tayt, ɔr nɔr de fil fayn na yu chɛst. Wi kin kɔl dis ``angina.'' Dis chɛst pen kin wɔs we yu de ɛksesaiz, klaym stɛp, ɔ taya smɔl.
• Kol swet.
• Diziz, layt ed, ɔ fil lɛk se yu nɔ gɛt bɛtɛ trɛnk.
• Taya pasmak ɛn wik.
• Fכ fil wan abnכmal at rεt (`Hat palpitεshכn`).
• Vɔmit.
• Fɔ blo shɔt, sɔntɛnde ivin we yu de waka fɔ shɔt tɛm.
• Pen na di sholda ɔ an (espɛshali di lɛft an).

If yu gɛt dɛn sik ya, yu fɔ go to dɔktɔ we yu nɔ fɔ west tɛm.

Aw dɛn kin no bɔt ‘in-stent restenosis’?

As a bin dɔn tɔk bifo tɛm, bikɔs `In-Stent Restenosis` nɔ kin sho di sik ɔltɛm, i impɔtant fɔ si yu dɔktɔ ɔltɛm afta dɛn dɔn put stent. Dɔn, dɛn kin du di tɛst dɛn we dɛn nid.

If yu gɛt sɔm sayn dɛn, yu dɔktɔ kin tɛl yu fɔ du tɛst lɛk dɛn wan ya:

• Ɛksesaiz strɛs tɛst : Dis tɛst de mɛzhɔ aw yu at de pɔmp blɔd ɛn luk fɔ chenj dɛn na yu ECG we yu de waka pan tredmil ɔ rayd baysikul.
• Kadyak kateshɔn ɛn angiogram : Dɛn kin du dis bifo dɛn put di stent. Dɛn kin du dis bak fɔ si ɛksaktɔli if blɔk de insay di stent.
• Koronari kɔmpyuta tomografi angiogram (CCTA): Dis tan lɛk CT skan. Dɛn kin put spɛshal day insay di at fɔ mek 3D pikchɔ dɛn bɔt di at in at.
• Fractional flow reserve (FFR): dis kin bi di sem tεm we di angiogram de du. Dɛn kin put spɛshal waya insay di vein ɛn dɛn kin mɛzhɔ di blɔd prɛshɔn na di tu say dɛn we di blɔk dɔn blo fɔ si aw di blɔk dɔn bad.
• Intravaskul ɔltrasɔund (IVUS): Dɛn kin du dis bak di sem tɛm we dɛn de du angiogram. wan sכmכl כltra saund prob de pas insay di vein, we de mek dεn si di insay pat pan di vein wכl εn di stent rili klia wan.

Wetin na di tritmɛnt dɛm fɔ ‘in-stent restenosis’?

Yu dɔktɔ go disayd di tritmɛnt we go fayn fɔ yu bay aw yu In-Stent Restenosis siriɔs, dat na aw di at de smɔl, ɛn yu ɔl wɛlbɔdi. I kin gɛt wan pan dɛn tritmɛnt ya:

• Mɛrɛsin dɛm: Fɔ kɔntrol di sayn dɛm lɛk angina we In-Stent Restenosis kin kam wit, dɛn kin ad di doz fɔ di mɛrɛsin dɛm we dɛn de yuz naw ɔ dɛn kin ad nyu mɛrɛsin dɛm.
• Ripit angioplasty: Dɛn kin mek di at we dɔn blok big bak wit balyɔn, ɛn sɔntɛnde dɛn kin put ɔda stent insay. Sɔntɛnde, dɛn kin yuz balyɔn we dɛn kɔt wit drɔgs.
• Ɔpreshɔn fɔ baypas di at:dis dεn kכl am bak `Koronary artery bypass grafting` כ `CABG`. Dis na smɔl big ɔpreshɔn. Wetin yu de du na fɔ mek nyu rod fɔ mek blɔd flɔ rawnd di say we dɛn dɔn blok. Dat min se yu tek wan pat pan di at frɔm ɔda pat na yu bɔdi (lɛk yu leg, chɛst) ɛn kɔnɛkt am to di say we dɔn blok ɛn bak.
• Vascular brachytherapy: Dis na tritmɛnt we difrɛn smɔl. Jɔs lɛk aw dɛn kin yuz redyushɔn fɔ kil di kansa sɛl dɛn, dis kin min fɔ gi smɔl raytin fɔ shɔt tɛm to di stent fɔ mek di ska tisu nɔ gro bak. Dɛn kin kɔl dis bak korona brakitɛrapi.

Yu tink se we dɛn de fɔ mek yu nɔ gɛt ‘in-stent restenosis’?

Yes, di gud nyus na dat di risk fɔ `In-Stent Restenosis` kin ridyus. wan pan di men we fכ du dis na fכ yuz drog-eluting stent (`DES`).

Dɛn `DES` ya difrɛn frɔm bare metal stent (BMS). Dɛn gɛt wan tin we tan lɛk mɛrɛsin pan dɛn. we dεn put di stent insay di vein, di mεdisin de kכmכt sכmtεm, we de kכntro di fכmeshכn fכ di ska tisu εn di growth fכ di sεl dεm.

Bɔku ia bifo naw, dɛn bin de tɔk bɔt di risk fɔ mek blɔd klɔt wit dɛn `DES` ya. Bɔt di nyu jɛnɛreshɔn fɔ stent dɛn we de pul drɔgs rili sef ɛn i rili wok. we yu de yuz dεn `DES` ya, di risk fכ `In-Stent Restenosis` de ridyus bכku bכku wan. fכ tכk roughly, `Fכs pas 1 pan 10 pipul dεm` de divεlכp `In-Stent Restenosis`.

So, if yu go mek dɛn put yu stent, tɔk to yu dɔktɔ fɔ disayd us kayn stent go fayn fɔ yu.

Wetin na de luk fɔ pɔrsin wae gɛt ‘in-stent restenosis’?

If yu gɛt `In-Stent Restenosis`, yu kin gɛt smɔl mɔ chans fɔ gɛt at prɔblɛm dɛn we kin mek yu layf de pan denja, lɛk `unstable angina`, `acute coronary syndrome`, ɛn `hat attack`.

Laki, dɛn risk ya dɔn ridyus bad bad wan wit di kam fɔ nyu stent (especially DES) ɛn impɔtant stent plesmɛnt tɛknik. Apat frɔm dat, naw dɛn gɛt fayn fayn tritmɛnt dɛn fɔ In-Stent Restenosis.

If yu gɛt CAD, yu fɔ fala yu dɔktɔ in instrɔkshɔn dɛn ɛksaktɔli fɔ mek yu nɔ gɛt In-Stent Restenosis ɛn fɔ protɛkt yu at in jɔnaral. Dat min se:

• Ridyus di sɔl we yu de it ɛn tek di mɛrɛsin dɛn we yu dɔktɔ tɛl yu fɔ tek (espɛshali di wan dɛn we de mek yu blɔd prɛshɔn, kɔlɔstrel, ɛn blɔd klɔt) ɛksaktɔli ɛn di rayt tɛm.
• Limit yu rɔm we yu de drink. If yu gɛt adikshɔn to rɔm, aks fɔ ɛp fɔ lɛf am.
• Di it we go ɛp yu atIt ``at-healthy diet.'' It smɔl ɔyl, shuga, ɛn flawa, ɛn it mɔ vɛjitebul, frut, ɛn it dɛn we gɛt fayv.
• Yu fɔ no di kayn fat dɛn we yu de it. Ridyus di it dɛn we yu de it we gɛt bɔku sɛtyuret ɛn trans fat (fast it, fried it, pak it) as yu ebul.
• Mek yu gɛt wɛlbɔdi wet. Ɛksesaiz ɛvride.
• If yu gɛt dayabitis, kɔntrol am fayn fayn wan.
• If yu de smok, tray fɔ lɛf fɔ smok tide. We dɛn de fɔ gɛt ɛp.

Ustɛm a fɔ kɔl dɔktɔ?

If yu tink se yu gɛt at atak (simptom dɛm lɛk fɔ gɛt siriɔs pen na yu chɛst, yu nɔ de blo fayn, yu de swet), kɔl di 1990 Suwaseriya Ambulans Savis wantɛm wantɛm.

If dɛn dɔn put yu stent bifo ɛn dɛn sik ya kin kam bak, go to yu dɔktɔ we de mɛn yu at wantɛm wantɛm:

• Chɛst pen (angina), tayt, prɛshɔn, pen na di an ɔ sholda.
• Kol swet.
• I nɔ izi fɔ blo, i de swɛt.
• Taya pasmak ɔ wik fɔ natin.

Wetin a fɔ aks mi dɔktɔ?

We yu mit di dɔktɔ, yu kin aks kwɛstyɔn dɛn lɛk dis fɔ ɔndastand yu sik klia wan:

• Wetin mek a geht dis `restenosis`? Wetin na di tin dɛn we kin mek a gɛt prɔblɛm?
• A kin gɛt restenosis bak? Wetin a fɔ du fɔ mek i nɔ apin?
• Us layf a fɔ fala fɔ protɛkt mi at?
• Us sayn dɛm fɔ kɔmplikeshɔn a fɔ luk fɔ?
• Wetin na di bɛst tritmɛnt fɔ mi?

Fɔ dɔn, wetin fɔ mɛmba (Take-Home Message) .

Okay, so di most impotant tin we yu nid fo memba from wetin wi don tok abaut na dis. Angioplasty ɛn stent na tu pan di tritmɛnt dɛn we impɔtant ɛn we de sev layf fɔ at sik. Dɛn tritmɛnt ya kin mek blɔd flɔ to yu at, i nɔ kin mek yu gɛt CAD, ɛn i kin mek yu layf bɛtɛ.

Bɔt if sɔm sayn dɛm lɛk fɔ taya, pen na yu chɛst, ɛn fɔ blo shɔt bak afta dɛn put stent, i kin bi sayn fɔ `In-Stent Restenosis.` If dat apin, nɔ panik ɔ delay, bɔt fɔ tru, go to yu dɔktɔ fɔ advays.

Laki, di nyu, saf drog-eluting stent dɛm we de tide dɔn ridyus di risk fɔ gɛt In-Stent Restenosis bad bad wan. Gud tritmɛnt dɛn de bak fɔ dis. I bɛtɛ fɔ tɔk to yu dɔktɔ bɔt us kayn stent ɛn tritmɛnt we fayn fɔ yu. Tek kia ɔf yu at!

` Stent, in-stent restenosis, hat sik, angioplasty, korona at sik, korona at sik, hat atak