I kawr chhunga thisen kalna kawngte chu a inkhar em? TCAR surgery (Transcarotid Artery Revascularization) chungchang i zir dawn a ni.

I doctor chuan i kawr chhunga thisen kalna kawng lian tak a inkhar tih leh stroke i neih theihna a sang hle tih a hrilh che em? Chutiang thil an hriat chuan tu pawhin tlem an hlauthawng hi thil pangngai tak a ni. "Ka zai a ngai dawn em ni? Thil lian tak a ni em?" Zawhna tam tak ka rilruah a lo lang ngei ang. Mahse lungngai suh, medical science a lo hmasawn tawh avangin tunah chuan hetiang dinhmun enkawlna him tak, awlsam leh tangkai tak tak a awm ta. Vawiin hian enkawlna thar leh hlawhtling ber pakhat TCAR chungchang kan sawi dawn a ni.

A awlsam zawngin TCAR chu eng nge ni?

TCAR hming kimchang chu Transcarotid Artery Revascularization tih a ni. Okay, he hming hi a buaithlak deuhin a ri a ni lawm ni? A awlsam zawngin i vawng ang u.

Kan kawr sir lehlamah thisen kalna kawng lian pahnih a awm a, chu chuan thluak lamah thisen a phur a. Hengte hi carotid arteries kan ti a . Hengte hi kan in chhunga tui rawn thlentu pipe lian pahnih ang mai a ni. Hun a kal zel a, kan ei tur atanga thau leh cholesterol ang chi thil te hi heng thisen kalna kawng chhungah hian a lo awm khawm a, tui pipe chhunga rust lo awm ang chi hi a ni. Hei hi damdawi lamah chuan ‘plaque’ an ti a.

He ‘plaque’ layer hi zawi zawiin a lian chho zel a, thisen kalna kawng chhunga hmun chu a tlahniam a, thisen kalna pawh a inkharkhip ta a ni. Thil hlauhawm ber chu he ‘plaque’ layer atanga a tlem ber chu a inthen a, thisen nen thluaka a kal chuan thluaka thisen kalna kawng a tikhawlo thei a, stroke a thlen thei a ni

Chuvangin, he thisen kalna kawng khar hi hawn leh a, thisen kal dan siamthat leh hi ‘revascularization’ kan tih hi a ni. Chutianga tih theih dan tlangpui engemaw zat a awm.

1. Carotid Endarterectomy (CEA): Hei hi hnam dan anga open surgery tih a ni. Hemiah hian a kawngah incision te tak te siamin, thisen kalna kawng chu hawn a, a chhunga ‘plaque’ layer chu lakchhuah a ni a, thisen kalna chu a inzawm khawm leh a ni.

2. Carotid Angioplasty and Senting (CAS): Tube te tak te tak mai chu groin emaw arm emaw chhunga thisen kalna kawng khat kaltlangin kawr chhunga thisen kalna kawngkhar blocked lam pan chuan a kal a. Chumi hnuah chuan a block lai chu balloon ang chi thil hmangin an tizau a, a khar leh loh nan ‘stent’ , mesh tube te tak te chu an dah lut a ni.

3. TCAR (Transcarotid Artery Revascularization): TCAR hi hmanraw him zawk, tunlai zawk, hmanraw pahnih zinga tha ber ber inzawmkhawm a ni. Chu chu kawr chhunga collarbone chungah chiah incision te tak te siam a, thisen kalna kawng khar chhungah direct-a stent dah a ni.

He TCAR surgery hi tu tan nge a inhmeh ber?

TCAR method hi kum 2015 khan traditional open surgery (CEA) atana risk sang tak nei damlote tan hman tan a ni. Chumi awmzia chu:

• Kum upa lam tan.
• Lung emaw lung natna nei tan chuan .
• Tun hmaa kawng surgery emaw radiation therapy emaw atanga scar tissue nei tan.
• Surgery harsana hmunah thisen kalna kawng a block a nih chuan, chu chu jawbone hnuaiah a ni.

Mahse tunah chuan he hmanraw hi a hlawhtling ta hle a, kum 2022 atang khan hriselna pangngai nei damlo, chu chu special risk factor nei lo tan pawh TCAR enkawl tura rawtna siam a ni ta a ni. Tun thlengin United States-ah ringawt pawh TCAR surgery 20,000 chuang tih a ni tawh a ni.

Operation hmain engtin nge i inbuatsaih thin?

I doctor chuan TCAR surgery tihsak che a tum a nih chuan test eng emaw zat a tih hmasak a ngai dawn a ni.

• Thisen test: I hriselna tlangpui leh thisen zam theihna te zawng rawh.
• Carotid artery ultrasound scan: Thisen kalna kawng engzat nge a block tih en rawh.
• CT Angiogram: Kawng leh thluaka thisen kalna kawng chiang zawk, three-dimensional image hmu rawh.

Tin, doctor chuan surgery atana inbuatsaih nan damdawi engemaw zat a ei tir ang che.

• Statin- type damdawi, cholesterol tihhniam thei.
• Thisen zam tur venna damdawi aspirin leh clopidogrel te.

Surgery hma zan zanlai hnuah engmah ei leh in lo turin hriattir i ni ang.

Surgery tih dan: step by step

He surgery hi darkar khat leh a chanve vel a ni ang. Operating room chhunga thil thlengte hi han thlir thuai teh ang.

1. Anesthesia: Natna engmah i neih loh nan i kawr vel chu a numbed ang (local anesthesia) emaw, anesthetized vek i ni ang (general anesthesia)

2. Small incision: Kawngpuiah hian incision te tak te tak tak siam a ni a, collarbone chunglam chiah, inches 1-1.5 vel a ni.

3. Flow Reversal: Hei hi TCAR kalphung atana pawimawh ber leh him ber a ni.

• Tube te tak te chu groin (femoral vein) chhunga vein pakhatah dah a ni.
• Tube dang chu a kawng incision hmangin carotid artery blocked chhungah dah a ni.
• Tunah chuan heng tube pahnih hi machine pakhatah filter bik hmangin an inzawm khawm ta a ni. Chumi hnuah chuan thluaka thisen kal chu hun eng emaw chen a tawp a, chu tube kaltlangin kawr chhunga thisen kalna atanga thisen chu a lo lut a, filter hmangin a tifai a, groin chhunga tube hmangin taksaah a kir leh ta a ni.
• Hetih lai hian i thluak mamawh thisen chu i kawr lehlamah carotid artery leh i thluak hnung lama vertebral arteries atanga lo chhuak a ni.Engmah daltu awm lovin a awm thei a ni.

4. Blockage hawn: Wire te tak te hmangin blockage piah lamah kal a, balloon te tak te hmangin a hmun zau zawk siam a ni.

5. Stent dah dan: A dawtah chuan metal mesh tube te tak te, stent an tih chu blockage chhungah dah a ni. Hei hian thisen kalna kawng chu a hawng reng a, plaque chu bang chungah a vawng tlat bawk.

6. A tawp: Tichuan, tube zawng zawng chu lakchhuah vek a ni a, thisen kalna kawngkhar te tak te leh a kawr chhunga incision te chu an sew up vek a.

Surgery hnuah eng nge thleng?

TCAR surgery hnuah chuan zan khat vel damdawi inah i awm a ngai dawn a ni . Doctor leh nurse ten i hriselna an enfiah reng ang. Hei hi surgery awlsam tak a nih avangin damna pawh a rang hle.

A hlauhawmna leh harsatna awm thei te chu engte nge ni?

Damdawi dang ang bawkin TCAR hian hlauhawmna tenau tak tak a keng tel thei a ni. Mahse, hengte hi a thlen theihna a tlem hle.

• Incision na hmun atanga thisen chhuak emaw, hring emaw.
• Incision atanga natna hrik awm.
• Kawngkhar chhunga nerve pakhat tihchhiat tenau.
• Thai.
• Lung natna.

I doctor chuan heng hlauhawmnate hi chipchiar zawkin a hrilhfiah ang che. TCAR kalpui chhung hian heng hlauhawmnate tih tlem nan hmalakna bik neih a ni tih hre reng ang che.

Stent hmanga dam leh nun

TCAR hi a rang hle a, a chhan chu incision lian tak a awm loh vang a ni.

• Kar khat emaw kar hnih emaw chhung chu rit phurh loh tur.
• Nitin i kawr chhunga incision chu enfiah thin la, a fai em tih leh hri kai chhinchhiahna a awm lo em tih enfiah thin ang che.
• Doctor hnenah engtikah nge i hnathawhna leh nitin hna dang i thawh leh theih ang tih zawt rawh.

Stent dah a nih hnuah thisen kalna kawng a inkhar leh tawh loh nan nangmah thu a ni. Chumi ti tur chuan heng thilte hi i tih a ngai a ni.

• Meizial i zuk chuan chawlhsan nghal rawh.
• Exercise neih fo thin ang che.
• Saturated fats tlemna ei leh in hrisel tak ei thin ang che.
• Thisen tithianghlimtu damdawi leh cholesterol tihhniamna damdawi doctor-in a pek chu a hun takah ei tur a ni.

Engtikah nge Doctor ka hmuh ang?

Incision site-ah infection chhinchhiahna i hmuh chuan doctor ko nghal rawh.

• Khawsik
• I vawt tih i hriat chuan
• Incision chhehvelah a sen leh a hring a awm chuan
• A cut atang hian liquid ang chi thil a chhuak a nih chuan

I doctor chuan eng enkawlna nge i tan a tha ber tih a rel ang. Zawhna, ngaihtuahna, rinhlelhna i neih apiang chu a hnênah sawipui rawh. A tum ber chu enkawl dan tur dik ber leh him ber pek che hi a ni.