Stent dah hnuah coronary artery chu a block leh thei ang em? (In-Stent Restenosis) tih a ni.

Nangmah emaw, i hriat emaw chuan coronary artery-ah stent dah tawh em? Chutianga enkawlna hnuah chuan tunah chuan buaina chu a chinfel vek tawh a, coronary artery chu a block leh tawh lo ang tih kan ngaihtuah fo thin. Mahse, a châng chuan stent dahna hmunah, chu chu enkawlna hmuna thisen kalna hmun khatah chuan blockage emaw, narrowing emaw tlem a awm leh thei a ni. Chu chu doctor-te’n ‘In-Stent Restenosis’ an tih chu a ni. A hming hi a buaithlak deuhin a lang thei a, mahse a takah chuan a awlsam khawp mai. Hemi chungchang hi chipchiar takin sawi ila, Sinhala tawngin i hriatthiam theih tur.

A hmasain, heng thute hi i hrethiam ang u, kan hrethiam dawn em ni?

‘In-stent restenosis’ kan sawi hma hian thumal tlemte hi han hrethiam ila. Tichuan i tan a chiang lehzual ang.

‘Stenosis’ tih hi eng nge ni?

A awlsam zawngin ‘stenosis’ tih hi kan taksaa thisen kalna kawng a zim emaw, a zim emaw a ni. Hun kal zelah tui pipe chhungah bawlhhlawh leh hnim hring a lo awm a, tui luang chhuak tur chu a tikhawlo niin han ngaihtuah teh.

Chuti a nih chuan, coronary artery disease (CAD) chu eng nge ni?

Kan thinlung pawh hian a thawh theih nan thisen a mamawh a ni. A supply tu artery lian ber berte chu coronary arteries an ti a. CAD chu coronary artery pakhat emaw a aia tam emaw chhungah plaque an tih fatty deposit a lo awm a, chu chuan arteries a ti tawi a ni. Hei hi atherosclerosis an ti bawk. Mi thenkhat chuan "hardening of the arteries" an ti bawk. Hetiang thau pung hi a thleng zauh zauh a, a tir lamah chuan a lan chhuah loh mai thei. Mahse enkawl loh chuan natna khirh tak tak, heart attack leh heart failure te a thlen thei a ni.

‘Angioplasty’ leh ‘Stent’ tih hi eng nge ni?

CAD vanga doctor-te’n coronary arteries blocked hawn nan an hman ber pakhat chu angioplasty an ti a. A chang chuan percutaneous coronary intervention (PCI) an ti bawk. Chutah chuan vunah khur te tak te hmangin thisen kalna kawngkhar (blocked artery) chhungah hian tube te tak te (catheter) dah a ni. Tube tawp lama balloon ang chi thil te tak te chu an inflated a, chu chuan artery block chu a tizau a ni. Tichuan, thisen kalna kawng chu a tlakbuak leh tawh loh nan leh thisen a kal tha theih nan, thisen kalna kawng zau tak chhungah chuan mesh tube te tak te – chu chu stent siamna tur a ni – dah a ni. Tichuan, thisen chu mumal takin a luang leh ta a.

Okay, tunah chuan he ‘In-Stent Restenosis’ hi eng nge ni?

Tunah chuan stent dah chhan leh dah dan chu i hrethiam ta. Stent dah a nih hnu leh coronary artery-a thisen kal dan a lo awm leh hnuah, a chang chuan stent dahna hmunah ngei, chu chu stent chhungah, thisen kalna chu a tawi leh tan thin. Chuvang chuan ‘In-Stent Restenosis’ kan ti a ni. 'Re' tih awmzia chu "again" tihna a ni a, 'stenosis' tih awmzia chu "narrowing" tihna a ni. Chuvangin, hei hi "stent chhunga narrowing again" tihna a ni.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Tunah chuan hei hi stent nei zawng zawng tan chuan thil danglam tak a ni em tih i ngaihtuah mai thei.Ni lo, hetiang hi stent nei zawng zawngah a thleng ngai lo. Mahse, a tlangpuiin sawi ila, stent nei mi 4 zinga 1 vel hian he natna `In-Stent Restenosis` an tih hi an vei theihna chance engemaw zat an nei a ni. Hei hi stent dah a nih atanga thla thum atanga thla ruk chhungin a thleng tlangpui.

Pawimawh: Stent dah loha balloon angioplasty i tih chuan restenosis hlauhawmna a sang zawk. Mi 10 zinga 4 vel chu an thisen kalna kawng (artery) a block leh dawn a ni.

Engvangin nge ‘in-stent restenosis’ hi a lo awm?

Zawhna ngaihnawm tak a ni tak zet. Stent kan dah hnuah kan taksa hian "tidam" a tum thin. Chu chu stent chungah cell layer thar (``new lining``) a lo thang lian a, chu chuan vein chhung chu a ti nem leh ta a ni. Hei hi a takah chuan thil tha tak a ni a, a chhan chu chutiang a nih chuan thisen chu awlsam zawkin a luang chhuak thei a, a clotting lo.

Mahse, a chang chuan he cell layer thar hnuaiah hian, stent chhehvelah hian scar tissue tlem a tam lutuk a lo thang lian thin. He scar tissue hi a lo lian lutuk chuan artery chhungril lining chu a thim a, thisen kal chu a ti tawi leh thin. Hei hi `In-Stent Restenosis` thlentu ber a ni.

Hei hi stent dah atanga thla thum atanga thla ruk chhungin a thleng tlangpui tih hre reng ang che. Chumi hnuah chuan scar tissue siam leh vein block theihna a tlem hle.

Tute nge ‘in-stent restenosis’ vei theihna sang zawk?

CAD atana stent dah tawh apiangin he natna `In-Stent Restenosis` an tih hi an nei thei a, mahse mi thenkhat chu an hlauhawmna a sang deuh hlek a ni. Tute nge an nih hi han thlir ila:

• Thisen cholesterol level sang nei tan. (Hei hi thinlung natna tam tak thlentu a ni!)
• Kidney natna nei tan chuan .
• Meizial zu thinte tan. (Hei hi i tih tawh loh tur thil a ni ngei ang!)
• Diabetes control tha lo nei tan chuan .
• Thisen sang (hypertension) thunun theih loh nei tan.

Hetiang dinhmun i neih chuan doctor nen inbiakna neihpui a, thunun theih a pawimawh hle.

‘In-stent restenosis’ natna lan chhuah dan chu engte nge ni?

A tam zawkah chuan `In-Stent Restenosis` vei te hian pawn lam atanga chhinchhiahna an nei lo. Chuvangin, a hun takah doctor hmuh a pawimawh hle a, stent dah a nih hnuah a tul anga test neih a pawimawh hle.

Mahse, mi thenkhat chuan symptoms an nei thei. An tih chuan a natna lan chhuah dan chu CAD awm tawh nen a inang fo thin. Chung zingah chuan:

• A rilru a na, a tight emaw, a nuam lo emaw tih hriatna. Hei hi ``angina'' kan ti a ni.He rilru natna hi exercise i tih hian, stairs i chhoh hian emaw, i chau deuh emaw hian a zual thei a ni.
• Thawmhnaw lum tak.
• Luak chhuak, lu hah, emaw, rilru hahna emaw.
• Chauh lutuk leh chak lohna.
• Heart rate dik lo (`Heart palpitations`) tih hriat.
• Luhai.
• Thâwk hahna, a châng chuan hla vak lo kal lai pawhin.
• A kekawrte emaw, kutphah emaw (a bik takin kut veilam) natna.

Heng symptoms te hi i neih chuan hun khawhral lova Doctor pan tur a ni.

Engtin nge ‘in-stent restenosis’ hi hriat chhuah a nih?

A hmaa ka sawi tawh ang khan `In-Stent Restenosis` hian symptom a lantir ngai loh avangin stent dah hnuah doctor pan fo a pawimawh hle. Tichuan, a tul ang test te pawh tih theih a ni.

Symptom i neih chuan i doctor chuan hetiang test hi a rawt thei ang:

• Exercise stress test : He test hian i thinlungin thisen a pump dan leh treadmill-a i kal emaw, bike i khalh lai emawa i ECG-a inthlak danglamna a zawn dan a teh a ni.
• Cardiac catheterization leh angiogram : Hei hi stent dah hmaa tih thin a ni. Hei hi stent chhungah blockage a awm em tih chiang taka hriat theih nan tih leh theih a ni.
• Coronary computed tomography angiogram (CCTA): Hei hi CT scan nen a inang hle. Thinlung chhungah hian dye bik an inject a, chu chuan thinlung thisen kalna kawng 3D image a siam a ni.
• Fractional flow reserve (FFR): Hei hi angiogram nen a rualin tih theih a ni. Vein chhungah hian wire bik dah a ni a, a blockage sir lehlamah thisen sang chu teh a ni a, blockage nasat zia hriat theih a ni.
• Intravascular ultrasound (IVUS): Hei hi angiogram nen a rualin tih theih a ni bawk. Ultrasound probe te tak te chu vein chhungah an pass a, chu chuan vein wall leh stent chhung lam chu chiang takin a hmu thei a ni.

‘In-stent restenosis’ enkawl dan tur chu engte nge ni?

I doctor chuan i In-Stent Restenosis nasat dan te, chu chu artery a zim dan te, leh i hriselna zawng zawng a zirin i tana enkawlna tha ber tur a ruat ang. A hnuaia enkawlna zinga pakhat a huam thei bawk:

• Damdawi: In-Stent Restenosis vanga angina ang chi symptoms control nan tuna damdawi hman mek hi tihpun emaw, damdawi thar dah belh emaw a ni thei.
• Angioplasty tih nawn leh: A thisen kalna kawng khar chu balloon hmangin an tizau leh a, a chang chuan stent dang an dah leh bawk. A châng chuan damdawi hmanga khuh balloon pawh hman theih a ni.
• Heart bypass hmanga operation tih hi:Hei hi `Coronary artery bypass grafting` emaw `CABG` emaw an ti bawk. Hei hi surgery lian tak a ni deuh ber. I tih tur chu a blocked area vel a thisen kal theihna tur kawng thar siam a ni. Chu chu i taksa peng dang (i ke, i rilru ang chi) atanga artery chi khat i la a, a blocked area leh back nen i thlunzawm tihna a ni.
• Vascular brachytherapy: Hei hi enkawlna danglam deuh a ni. Cancer cell tihhlumna atana hman radiation therapy ang bawkin, hei hian stent-ah hun rei lote chhung radiation tlemte pek a, chu chuan scar tissue chu a lo thang leh tawh lo ang. Hei hi coronary brachytherapy an ti bawk.

‘In-stent restenosis’ ven dan tur a awm em?

Ni e, thu lawmawm tak chu `In-Stent Restenosis` hlauhawmna hi tihziaawm theih a ni. Chutianga tih theih dan ber pakhat chu drug-eluting stent (`DES`) hman hi a ni.

Heng `DES` te hi bare metal stent (BMS) nen a danglam a ni. Damdawi coating te tak te an nei a. Stent hi vein chhunga dah a nih veleh damdawi chu zawi zawiin a chhuak a, scar tissue siam dan leh cells than dan a control a ni.

Kum tam tak kalta khan heng `DES` hmang hian thisen zam a awm theih thu sawi a awm a. Mahse, drug-eluting stent thar hi a him hle a, a hlawk hle bawk. Heng `DES` te hi hman hian `In-Stent Restenosis` vei theihna hi nasa takin a tlahniam a ni. A tlangpuiin `Mi 10 zinga 1 aia tlem lo` hian `In-Stent Restenosis` an vei thin.

Chuvangin, stent dah tur i nih chuan i doctor nen inbia la, eng stent chi nge i tan a tha ber tih rel rawh.

‘In-stent restenosis’ vei tan chuan eng nge a hmalam hun?

`In-Stent Restenosis` i vei chuan nunna atana hlauhawm thei thinlung natna, `unstable angina`, `acute coronary syndrome`, leh `heart attack` te i tawk tlem zawk mai thei.

Vanneihthlak takin stent thar (a bik takin DES) leh stent dah dan tha zawk a lo chhuah tak avangin heng hlauhawmnate hi nasa takin a tlahniam ta a ni. Hei bakah hian tunah hian In-Stent Restenosis enkawlna tha tak tak a awm tawh bawk.

CAD i neih chuan In-Stent Restenosis laka invenna tur leh a tlangpuiin i thinlung venhimna atan doctor thupek dik takin i zawm tur a ni. Chumi awmzia chu:

• Salt ei tlem la, i doctor-in a pek damdawi (a bik takin thisen sang, cholesterol, leh thisen zam) te chu dik tak leh a hun takah ei rawh.
• Zu in hi tihtlem rawh. Zu ruihhlo ngawlvei i nih chuan a hneh theih nan tanpuina zawng rawh.
• Lung hrisel ei leh in``Thinlung hrisel ei tur.'' Oil, sugar, leh flour ei tlem la, thlai, thei leh fiber tamna ei tur tam zawk ei bawk ang che.
• I ei tur thau chi hrang hrangte hi fimkhur rawh. Saturated leh trans fats tamna ei tur (fast food, fried foods, packaged foods) a theih ang angin tihtlem rawh.
• I taksa rihna hrisel tak vawng reng rawh. Nitin exercise la.
• Zunthlum i neih chuan control tha rawh.
• Meizial i zuk chuan vawiin hian bansan tum ang che. Ṭanpuina dawn theih dan a awm.

Engtikah nge doctor ka koh ang?

Heart attack (symptoms, rilru na tak, thawk hah, thawk hah ang chi) i nei nia i hriat chuan 1990 Suwaseriya Ambulance Service biak nghal rawh.

Stent i lo dah tawh a, heng symptoms te hi a lo lang leh a nih chuan i cardiologist hmu nghal rawh:

• Chest na (angina), tightness, pressure, kut emaw kephah emaw na.
• Thawmhnaw lum tak.
• Thâwk harsa, thawk hah.
• Chhan awm lova hah lutuk emaw, chak lohna emaw.

Ka doctor hnenah eng nge ka zawh ang?

Doctor i hmuh hian i dinhmun chiang taka i hriat theih nan hetiang zawhna hi i zawt thei ang:

• Engvangin nge he `restenosis` hi ka neih? Ka risk factors te chu engte nge ni?
• Restenosis ka nei leh thei ang em? Engtin nge ka tih ang?
• Ka thinlung venhim nan eng nunphung nge ka zawm ang?
• Eng harsatna chhinchhiahna nge ka fimkhur tur?
• Ka tan enge inenkawlna tha ber?

A tawp berah chuan hriat reng tur (Take-Home Message) .

Okay, chuvangin kan sawi tawh atang khan i hriat reng tur pawimawh ber chu hei hi a ni. Angioplasty leh stenting hi thinlung natna enkawlna pawimawh leh nunna chhanhimtu pahnih a ni. Heng enkawlnate hian i thinlungah thisen a kal tha a, CAD symptoms a ti tlem a, i nunphung a ti tha bawk.

Mahse, stent dah hnua hahna, rilru na, thawk hahna ang chi symptoms a lo lang leh a nih chuan `In-Stent Restenosis` chhinchhiahna a ni thei a ni .

Vanneihthlak takin tunlaia drug-eluting stent thar, him zawk awmte hian In-Stent Restenosis vei theihna nasa takin a ti tlem a ni. Hemi atan hian enkawlna tha tak tak a awm bawk. Eng ang stent nge i hman ang tih leh eng enkawlna nge i tana tha ber tih hi doctor nen inbiakna neih a tha ber. I thinlung kha enkawl rawh!

` Stents, in-stent restenosis, thinlung natna, angioplasty, coronary artery natna, coronary artery disease, heart attack te a awm thei