Ese uzi indwara yitwa 'Endoleak' ibaho nyuma yo kuvurwa na aneurysm?

Wigeze wumva `Aneurysm`, indwara aho urukuta rw'umuyoboro w'amaraso cyangwa umuyoboro munini w'amaraso mu mubiri rucika intege kandi rukabyimba nk'umupira w'amapine? Wenda wigeze kurwara, kandi abaganga barawuvuraga bashyiramo umuyoboro muto witwa `Stent Graft`, ari na bwo buryo bwitwa `Endovascular`, bivuze ko nta gukata cyane. Tekereza nk'aho amazi ava mu muyoboro w'amazi ushaje. Bityo abaganga bashyiramo undi muyoboro mu mwobo kugira ngo bawukomeze. Ariko, rimwe na rimwe nyuma y'ubwo buryo bwo kuvurwa, amaraso make atangira kuva muri `Stent Graft`, mu gafuka aho `Aneurysm` yahoze. Ibyo ni byo twita `Endoleak` mu buvuzi. Uyu munsi, turaganira birambuye ku byo ibi ari byo koko, impamvu bibaho, niba ari akaga, uburyo bwo kubitahura, n'uburyo bwo kuvura.

Mu by'ukuri `Endoleak` ni iki?

Mu magambo make, `Endoleak` bivuze ko nyuma yuko `Aneurysm` imaze kuvurwa no gufungwa, amaraso atangira kongera gutembera mu gafuka ka `Aneurysm` gashaje. Noneho, reba, ubusanzwe iyo `Aneurysm` ivuwe, amaraso yawe anyura gusa mu muyoboro mushya wa `Stent Graft`. Iyi `Stent Graft` ni nk'inkingi y'urukuta rw'imitsi y'amaraso rwacitse intege. Kubwibyo, amaraso ntatembera mu gice cy'imitsi y'amaraso cyangiritse, ni ukuvuga `Aneurysm Sac`. Hanyuma `Aneurysm` irahagarara gukura no guturika. Byaba byiza niba nta maraso arimo kuva.

Ariko, niba ku mpamvu runaka amaraso ava hanze ya `Stent Graft` akagera muri `Aneurysm Sac`, ibyo byitwa `Endoleak`. Hari impamvu zitandukanye zituma iyi `Endoleak` ibaho. Zimwe muri zo ziterwa n'ibibazo bya `Graft` ubwayo, kandi zimwe muri zo zishobora guterwa n'indi mitsi mito y'amaraso itangira kuri `Aneurysm Sac`. Ni nk'amazi ava ahantu hamwe na hamwe nyuma yo gufungura igisenge.

Iyo `Endoleak` ibaye mu minsi 30 nyuma y'ubu buvuzi bwa `Endovascular`, tuyita ``endoleaks zo hakiri kare`` . Izivuka nyuma y'iminsi 30 zitwa ``endoleaks zo mu cyiciro cya kabiri`` cyangwa ``endoleaks zo mu cyiciro cya nyuma`` .

`Endoleak` ikunze kugaragara gute?

Ubu ushobora kuba wibaza niba iyi 'Endoleak' ari ikintu kiba kuri buri wese cyangwa ari ikintu kidakunze kubaho. Mu by'ukuri, iyi ndwara ya 'Endoleak' ishobora kubaho ku muntu umwe kuri bane bakora 'Endovascular Aneurysm Repair' (tuyita 'EVAR' mu magambo ahinnye - ubu ni uburyo bwo kuvura ahanini 'Aneurysm' mu rukuta rw'inda) cyangwa 'Treacic Endovascular Aneurysm Repair' ('TEVAR') kuri 'Aneurysm' mu gituza . Rero, ntabwo ari ikintu kidasanzwe. Niyo mpamvu ari ngombwa cyane kubimenya.

Ese `Endoleak` iteje akaga?

Ibi bishobora kugutera ubwoba gato. "Oh, ndatinya ko bizongera kuva amaraso, si byo se?" Ariko si ko endoleak zose ziteje akaga . Endoleak zimwe na zimwe ntizitera ingaruka mbi kandi zigakira ubwazo. Nk'uko igikomere gito gikira ubwacyo. Muri ibyo bihe, muganga wawe ashobora gufata icyemezo cyo gukurikirana gusa ikibazo cyawe. Ibi bivuze gukomeza gukora ibizamini no kureba ikibaye.

Ariko, hari ubwoko bumwe bwa 'Endoleak' bukabije kurushaho. Kugira ngo hirindwe ko 'Aneurysm' ishobora kongera kwiyongera no guturika, igomba kuvurwa vuba. Kuko iyo 'Aneurysm' iturika, ishobora gushyira ubuzima mu kaga. Rero, niba ibi biteje akaga cyangwa bitateye ubwoba biterwa n'ubwoko bwa 'Endoleak' n'aho iherereye. Abaganga bafata ibyemezo bashingiye kuri ibi bintu byose.

Ni ubuhe bwoko bwa 'Endoleak' buriho?

Ubu hari ubwoko butanu bwa 'Endoleak' bwamenyekanye. Buri bwoko bufite impamvu itandukanye. Nk'uko buri ndwara ifite impamvu yayo. Hamwe n'iterambere ry'ikoranabuhanga rishya rya 'Stent Graft', ubwoko bumwe bwa 'Endoleak' bwagabanutseho gato, ibyo bikaba ari byiza.

Muri izi , `Endoleak yo mu bwoko bwa 2` ni yo ikunze kugaragara cyane . Ariko , `Endoleak yo mu bwoko bwa 1` na `Endoleak yo mu bwoko bwa 3` ni zo ziteje akaga gato , kuko zongerera ibyago byo guturika kwa `Aneurysm` (`rupturing`). Reka turebere hamwe ubwo bwoko neza.

`Ubwoko bwa 1 Endoleak`

Ibi bibaho iyo agace k’umuyoboro w’amaraso kadafatanye neza n’urukuta rw’imitsi, bivuze ko kadafunze neza. Tekereza, niba hari umwanya muto hagati y’igipfukisho n’urukuta, amazi azava aho, maze amaraso akava mu mpera yo hejuru (proximal) cyangwa mu mpera yo hasi (distal) y’agace k’umuyoboro w’amaraso maze akajya mu gasabo k’amaraso afite amaraso menshi. Indwara ya endoleak yo mu bwoko bwa 1 ni indwara ikomeye, bityo ikenera kuvurwa vuba. Iyi ndwara ishobora kwangiza aneurysm kurusha izindi. Abaganga nibabibona, bazafata ingamba vuba.

`Ubwoko bwa 2 Endoleak`

Ubu ni bwo bwoko bwa endoleak bukunze kugaragara cyane . Bukunze kugaragara nyuma ya EVAR kurusha TEVAR ku ndwara zo mu nda. Uku kuvoma bibaho iyo amaraso ava mu mitsi yawe cyangwa mu mitsi ifite stent yinjira mu gasabo ka aneurysm binyuze mu mitsi mito y'amaraso (imitsi y'amashami cyangwa imitsi y'inyongera). Tekereza ko aorta yawe ifite amashami mato (amashami). Noneho, nubwo twashyiramo stent graft nshya kugira ngo dufunge umwobo muri aorta, hari amaraso ashobora kuva muri ayo mashami. Uko ni ko endoleak yo mu bwoko bwa 2 imeze.

Akenshi, indwara ya Endoleak yo mu bwoko bwa 2 ipimwa mu minsi 30 nyuma yo kuvurwa n'imitsi. Ariko, rimwe na rimwe ishobora kugaragara nyuma, izwi nka "endoleaks za nyuma." Hafi 40% by'indwara ya Endoleak yo mu bwoko bwa 2 ipimwa nyuma y'iminsi 30. Hafi 8% by'indwara ya Endoleaks yo mu bwoko bwa 2 ipimwa nyuma y'umwaka umwe ivurwa.

Ariko `Endoleaks` nyinshi zo mu bwoko bwa 2 ntabwo ari mbi cyane . Zigenda zikira zonyine nyuma y'amezi atandatu nta muti. Kubera ko iyo mitsi mito y'amaraso ifunga ubwayo. Nubwo itagenda ikira, niba `Aneurysm Sac` ihamye kandi idakura, muganga ashobora kuyikurikirana. Ariko rimwe na rimwe, uko igihe kigenda gihita, iyi `Endoleaks zo mu bwoko bwa 2` ishobora guteza impinduka muri `Aneurysm Sac` igahinduka `Endoleak` iteje akaga cyane nka `Type 1` cyangwa `Type 3`. Iyo bibaye, ubuvuzi burakenewe. Niba `Aneurysm` irengeje milimetero 5 (`5mm`), ushobora gukenera ubuvuzi. Niba `Aneurysm` itavuwe, hari amahirwe ko `Aneurysm` yaturika.

`Ubwoko bwa 3 Endoleak`

Endoleak yo mu bwoko bwa 3 ibaho iyo ibice bya modular bya stent graft yawe bitandukanye, cyangwa niba igitambaro cya graft ubwayo cyacitse cyangwa kigacika. Ibi bisa n'umuyoboro witandukanya ku ngingo, cyangwa umwobo ugakora mu muyoboro ubwawo. Kimwe na Endoleak yo mu bwoko bwa 1, hari ibyago byo guturika kwa aneurysm kuko amaraso atembera mu gafuka ka aneurysm bitewe n'umuvuduko. Kubwibyo, ni ngombwa kuvurwa vuba. Ariko, hamwe n'iterambere mu miterere y'igikoresho, Endoleak yo mu bwoko bwa 3 ni gake cyane.

`Ubwoko bwa 4 Endoleak`

Ibi bibaho iyo amaraso atemba anyuze mu mwobo muto uri muri stent graft (imyenge y'ibikoresho bya graft). Ibi bikunze kugaragara mu ntangiriro z'ubuvuzi, ariko akenshi bikemuka ubwabyo. Iyi ni ingorane idakunze kubaho kuri graft, kandi ntabwo ikunze kugaragara cyane kuri grafts zikoreshwa muri iki gihe.

`Ubwoko bwa 5 Endoleak`

`Endoleak yo mu bwoko bwa 5` yitwa kandi ``Endotension``. Ibi biratangaje gato. Ikibaho muri uru rubanza ni uko, nubwo nta kimenyetso cya ``Endoleak`` kigaragara ku bizamini bya ``Ishusho``, ``Aneurysm Sac`` ikomeje kwiyongera. Nubwo impamvu nyayo y'ibi itazwi neza, bikekwa ko hashobora kuba hari ``pressure transmission``` binyuze muri ``Stent Graft```, nubwo nta maraso agaragara ava. Iyi nayo ni indwara igomba gukurikiranwa.

Ni ibihe bimenyetso by'indwara ya `Endoleak`?

Iki ni cyo kibazo abantu benshi bagira. Akenshi nta bimenyetso wakwitega kubona niba ufite endoleak. Ushobora kutabona itandukaniro iryo ari ryo ryose. Endoleak iboneka hakoreshejwe ibizamini byakorewe ku munsi w'ubuvuzi bwawe ndetse no mu bizamini bikurikira byakozwe nyuma yaho.Niyo mpamvu ari ingenzi cyane kujya muri ibyo bipimo byo gukurikirana. Kujya kwipimisha neza neza ku matariki muganga avuga ko ari bwo buryo bwonyine bwo kumenya ikintu nk'iki vuba.

Ariko, iyo aneurysm ibaye nini kandi ikavunika (aneurysm ikavunika) bitewe na endoleak (cyane cyane ubwoko buteje akaga), ni ikibazo cyihutirwa cy’ubuvuzi . Ibi bibaye, ibimenyetso bikurikira bishobora kubaho. Ibi bibaye , ugomba guhamagara 911 cyangwa ujya kwa muganga wihuta :

• Umubiri ukonje kandi wuzuye ibyuya (`Uruhu rumeze nk'urubura, rwuzuye ibyuya`).
• Kuzungera, kumva uzunguruka mu mutwe.
• Kunanirwa, guta ubwenge.
• Umutima utera vuba cyane (`Umutima utera vuba`).
• Isesemi no kuruka.
• Kugorwa no guhumeka, kumva urimo guhumeka (guhumeka nabi).
• Ububabare butunguranye, bukabije mu nda, mu mugongo wo hasi cyangwa mu maguru.
• Ububabare butunguranye kandi bukabije mu gituza cyangwa mu mugongo.

Niba ibi bimenyetso bigaragaye, ntutinde.

Ni gute wabona `Endoleak`?

Nkuko byavuzwe mbere, endoleak ipimwa binyuze mu isuzuma ry’amashusho. Ibi bizamini bikorwa mu gihe cyo gusana na nyuma y’uko uvuwe. Akenshi, ipimwa umunsi umwe cyangwa mu minsi 30 nyuma yo kuvurwa. Ariko, rimwe na rimwe ishobora kubaho kugeza ku mezi 12 cyangwa irenga. Niyo mpamvu ari ngombwa cyane gukomeza gahunda zawe zose zo gukurikirana. Kimwe no gusukura imodoka, iki ni ikintu kigomba kwitabwaho buri gihe.

Ibizamini byo gutahura `Endoleak`

Ibipimo by'ingenzi bikoreshwa mu gusuzuma `Endoleak` mu gihe cyo kuvurwa na nyuma yaho ni ibi bikurikira:

• `Isuzuma rya CT (Computed Tomography): Ibi bifotora imbere mu mubiri mu buryo burambuye. `Stent Graft`, `Aneurysm Sac`, n'amaraso avamo biragaragara neza.
• Doppler Ultrasound: Iyi ultrasound ikoresha imiraba y'amajwi kugira ngo irebe uko amaraso atembera. Ishobora kumenya niba hari endoleak n'uko amaraso atembera.
• Angiogramu: Muri ibi, hashyirwamo amazi yihariye (irangi ritandukanye) mu miyoboro y'amaraso hanyuma hagafatwa amashusho ya X-ray. Amaraso atembera neza n'amazi ava mu mubiri biragaragara neza.

Ibi bizamini bishobora gufasha kumenya niba ubuvuzi bwawe bwagenze neza, niba agace ka stent gafite, ndetse niba hari aho kamenetse hafi ya stent.

Uzakenera gukora ibi bizamini bya 'imaging' mu mezi cyangwa imyaka nyuma yo kuvurwa. Muganga wawe azakubwira ibi bizamini n'inshuro ugomba kubikora. Ariko, ibi bizamini ni ingenzi kugira ngo ufate 'endoleak' iyo ari yo yose ishobora kuvuka nyuma ('endoleaks' z'inyongera) vuba kandi uyivure nibiba ngombwa.

Ni ubuhe buryo bwo kuvura `Endoleak`?

Itsinda ry'abaganga bawe rizavura Endoleak yawe hakurikijwe ibyo ukeneye ku giti cyawe. Uburyo Endoleak ivurwa buratandukanye kuri buri muntu. Ibi bizaterwa n'ubwoko bw'umubiri wawe (urugero, uburebure bw'ijosi ryawe, aho imiyoboro y'amaraso iherereye, nibindi), ubwoko bwa Endoleak, n'aho iherereye. Muri rusange, hari amahitamo atatu y'ingenzi yo kuvura Endoleak: kwitegereza, kuvura imiyoboro y'amaraso, cyangwa kubagwa mu buryo bwihuse.

Kwitegereza

Niba ufite ubwoko bwa endoleak budakomeye cyane, nka endoleak yo mu bwoko bwa 2, muganga wawe ashobora kukugira inama yo "gutegereza witonze" kugira ngo arebe niba izakira ubwayo. Ibi bishobora kubaho iyo imiyoboro y'amaraso ihujwe ipfutse (ipfutse), igahagarika amaraso yinjira mu gasanduku ka aneurysm. Ariko, niba endoleak itera agasanduku ka aneurysm kuba kanini (ni ukuvuga kanini kurusha mm 5), uzakenera kuvurwa kugira ngo wirinde gucika.

Kuvura imitsi yo mu nda

Ubu ni bwo buryo bukunze kuvura indwara ya aneurysm yo mu mitsi. Umuganga wawe ubaga imitsi ashobora gusana aneurysm yo mu mitsi akoresheje uburyo budakoresha imbaraga nyinshi. Ibi bishobora kuba birimo:

• Gufunga imiyoboro y'amaraso y'ishami itanga amaraso muri aneurysm. Ni ukuvuga ko hari ikintu cyihariye (embolizing agent) gishyirwa mu miyoboro mito y'amaraso itera Endoleak yo mu bwoko bwa 2 maze igafungwa.
• `Stent Graft` ni uburyo busaba gushyira ibindi bice bya `Stent` (`cuffs cyangwa extenders`) inyuma y'aho amazi yamenetse, bikagura agace k'imitsi migari (`Aorta`) aho `Stent` yashyizwe. Ibi bikunze gukorwa kuri `Type 1 Endoleak`.
• Kujya mu gasanduku ka aneurysm hanyuma ugafunga agasanduku ka aneurysm ukoresheje ibikoresho bimeze nk'ibirahure.

Ubu buryo butuma ubuvuzi bukorwa nta gukata gukomeye, binyuze mu mwobo muto.

Kubaga ('Kubagwa ku mugaragaro')

Iyo ubuvuzi bwo kuvura imitsi yo mu nda budashoboka cyangwa bukananirana, kubagwa ku mugaragaro akenshi ni bwo buryo bwa nyuma. Ibi bisaba gukata igice kinini, kujya mu mitsi yo mu nda, no gusana stent graft cyangwa gushyiramo indi nshya. Ibi ni gake cyane, kuko ubu buryo bwo kuvura imitsi yo mu nda buteye imbere cyane.

Ni iki wakwitega niba ufite `endoleak`?

Akenshi, Endoleak ntikenera ubuvuzi, cyane cyane ubwoko bwa 2. Nubwo byaba bikenewe ubuvuzi, hari uburyo bwinshi bwo kuvura budasaba gucibwamo ibice bike. Ubu buryo bwo kuvura Endoleas bwagaragaje ko bufite ingaruka nziza cyane. Byongeye kandi, ikoranabuhanga rishya rikomeje kunoza ikoreshwa rya stent grafts zigabanya ibyago byo kwandura Endoleak.

Niba ufite endoleak, ntugatinye. Muganga wawe azagusobanurira uburyo bwo kuvura. Icy'ingenzi ni uko uzakomeza gukorerwa ibizamini byo gukurikirana ndetse na nyuma yuko endoleak ikize.Ni ingenzi cyane kumenya no kuvura ibibazo byose bizaza bijyanye na stent graft yawe vuba bishoboka, kimwe no kubungabunga imodoka.

Ni ryari ngomba kubonana na muganga wanjye?

Menya neza ko ukurikiza gahunda zose zo gukurikirana nyuma yo kuvurwa na EVAR cyangwa TEVAR. Muganga wawe azakubwira inshuro ugomba gukorerwa ibizamini byo gufata amashusho. Ubusanzwe, bizarushaho kuba byegeranye mu ntangiriro, ariko bishobora kwiyongera uko igihe kigenda gihita. Kurikiza ayo mabwiriza neza.

Nanone, niba ubonye ibimenyetso byihutirwa bizana no gucika kw'imitsi yo mu bwonko, nk'uko byavuzwe mbere, jya kwa muganga vuba udategereje.

Ibibazo byo kubaza muganga wawe

Nyuma yo kubagwa na EVAR cyangwa TEVAR, baza muganga wawe ingaruka zishobora guterwa n'ingaruka mbi. Nanone, vuga ku bipimo byo gukurikirana n'ibizamini byo gupima. Ushobora kubaza ibibazo nka:

• Ni izihe ngaruka mbi zishobora guterwa n'ubu buvuzi? Ni izihe ngaruka mbi mfite zo kurwara endoleak?
• Ni kangahe ngomba kuza gukurikirana? Ni ibihe bipimo (nk'ibya CT, ultrasound) nzakenera gukora?
• Ni ubuhe buryo bwo kuvura mfite mu gihe numvise `endoleak`?
• Ni izihe mpinduka mu mibereho yanjye nshobora gukora kugira ngo umutima wanjye ugire ubuzima bwiza kandi stent graft yanjye ikomeze kuba nziza? (urugero: kureka kunywa itabi, gukora imyitozo ngororamubiri, indyo yuzuye)

Ni ingenzi cyane kubaza ibibazo nk'ibi no gusobanukirwa neza uko umerewe.

Ni ubuhe butumwa dushobora kujyana mu nkuru?

Endoleak ni ikibazo gishobora gukemuka gishobora kubaho nyuma yo gusana aneurysm y'imitsi. Ushobora kuba udakeneye ubuvuzi ubwo aribwo bwose. Ariko, nubikora, muganga wawe azakubwira uburyo bwo kuvura bukubereye.

Ni ibisanzwe ko ingorane nk'izi zibaho nyuma yo kubagwa ubuzima, nko kuvura aneurysm. Ariko, inyungu z'ubu buryo ziruta kure ingaruka . Ntugatinye rero niba umenye iby'indwara ya endoleak.

Icy'ingenzi ni ukujya kwa muganga ukurikirana indwara, hanyuma ugahabwa ibizamini agusaba. Muri ubwo buryo, ibibazo byose bishobora kumenyekana no kuvurwa vuba.

Niba wumva unaniwe kandi uremerewe, ni ibisanzwe. Abantu benshi bahura n'ibintu nk'ibyawe. Vugana na muganga wawe n'umuryango wawe ku buryo bwo guhangana n'imihangayiko iterwa no gukira. Ntabwo uri wenyine.

Endoleak , Aneurysm, Stent Graft, EVAR, TEVAR, Kuva amaraso, Aneurysm, Stent Graft, Indwara z'Umutima