Ushobora kuba wibaza ukuntu indwara yo gucika kw'imitsi yo mu bwonko ari mbi cyane. Impamvu nyamukuru ibitera ni uko imitsi y'amaraso y'ingenzi cyane (imitsi ya carotid) iri ku mpande zombi z'ijosi ryacu ijyana amaraso mu bwonko ifungwa n'ibinure byinshi. Ni nk'ingese ziyongera mu muyoboro w'amazi zikawufunga buhoro buhoro. Ariko ntugahangayike, ubu hari uburyo bwo kuvura bugezweho kandi bworoshye. Ni byo tuvuga uyu munsi.
Ubu buryo bwitwa TFCAS ni ubuhe?
Mu magambo make, Transfemoral Carotid Artery Stenting (TFCAS) ni uburyo budakoresha imbaraga nyinshi bukoreshwa mu gufungura umutsi wa carotid wazibye mu ijosi. Bisaba gushyiramo umuyoboro muto cyane umeze nk'umuyoboro, witwa stent, mu mutsi wazibye kugira ngo wongere ukwaguka.
Tekereza nawe, imitsi ya carotide iri ku mpande zombi z'ijosi ryacu ni yo mitsi ibiri y'ingenzi itwara ogisijeni n'intungamubiri mu bwonko bwacu, mu maso no mu ijosi. Uko igihe kigenda gihita, cholesterol n'ibinure biva mu biribwa turya bitangira kwirundanya mu nkuta z'iyi mitsi. Iyi plaque twita. Iyi plaque itera inkuta z'imitsi gukomera no gukomera (atherosclerosis). Amaherezo, imitsi y'amaraso iragabanuka (stenosis). Iyo iyi miyoboro y'amaraso ibuze, amaraso agera mu bwonko aragabanuka, bikongera cyane ibyago byo kurwara indwara yo gucika intege.
Mu kuvura TFCAS, umuyoboro wihariye (catheter) ushyirwa mu kantu gato cyane mu kibuno cyawe cyangwa ku kuboko hanyuma ukajyanwa ku mutsi ufunze mu ijosi ryawe. Hanyuma stent ishyirwamo binyuze muri catheter kugira ngo wongere gufungura umutsi. Stent, nk'inkingi y'ihema, ifasha umutsi kudasubira kugwa. Ibi bigarura amaraso mu bwonko, bigabanya ibyago byo kurwara indwara yo gucika kw'imitsi.
Ni nde ukeneye ubu buvuzi?
Ubu buryo bwo kuvura bushobora kuba bwiza iyo muganga wawe asanze ufite indwara y'imitsi itera amaraso mu mubiri (carotid artery disease). Hari igihe ushobora kuba udafite ibimenyetso na gato. Ariko, hari abantu bashobora kugira ibimenyetso bisa n'ibiba bya mini-stroke (cyangwa ibitero by'imisemburo by'igihe gito - TIAs).
Ubusanzwe hari uburyo butandukanye bwo kuvura indwara ya carotid artery stenosis. Muganga wawe azaguhitiramo uburyo bwiza bwo kuvura bitewe n'uko ubuzima bwawe bumeze, imiterere y'imitsi, n'aho stenosis iherereye.
Igikuru ni ukuganira na muganga wawe uburyo bwo kuvura muri ubu buryo bukubereye.
| Uburyo bwo kuvura | Ni iki kibaho gusa | Umwihariko |
|---|---|---|
| TFCAS (uburyo bwavuzwe muri iyi nkuru) | Gushyira stent mu mutsi uri mu ijosi ukoresheje umuyoboro winjizwa mu kibuno cyangwa mu kuboko. | Nta kibazo gikomeye gihari. Igihe cyo gukira ni gito. |
| Kubaga indwara ya Carotid Endarterectomy (CEA) | Hakorwa icyuho mu ijosi, imitsi irafungurwa, hanyuma urwego rw'ibinure (plaque) rwakusanyijeho rurakurwaho. | Kubaga gakondo byakorewe abantu benshi. |
| Gutera amenyo ya Transcarotide (TCAR) | Hakorwa akato gato mu ijosi hejuru gato y'igufwa ry'umugongo hanyuma stent igashyirwa mu mitsi. | Ubushakashatsi bumwe bwagaragaje ko ifite ibyago bike byo kurwara indwara yo mu bwonko ugereranyije na TFCAS. |
Ni nde ubuvuzi bwa TFCAS bukwiriye kurusha ubundi?
Ubuvuzi bwa TFCAS bushobora kuba bwiza kuri wewe kuruta kubagwa kwa CEA niba ufite ibi bintu bishobora gutera ibyago:
- Iyo umutsi ufunze ahantu hatagerwaho byoroshye hakoreshejwe uburyo bwo kubaga.
- Niba ufite izindi ngorane z'ubuzima (comorbidities) nk'indwara z'umutima, indwara z'ibihaha, cyangwa umubyibuho ukabije.
- Niba ufite inkovu ku ijosi bitewe n'uko wabanje kubagwa cyangwa kuvurwa hakoreshejwe imirasire.
- Niba imitsi y'ijwi ryawe yangiritse.
Witegura ute mbere yo kubagwa?
Mbere y'uko ubagwa, muganga wawe ashobora kugusaba:
- Kora ibizamini by'amaraso n'ibindi bipimo by'ubuzima.
- Gira echocardiogram cyangwa ikizamini cy'imihangayiko kugira ngo urebe imikorere y'umutima.
- Kora ikizamini cyo gufata amashusho nka `carotid angiography`, `vascular ultrasound`, cyangwa `MRA` kugira ngo urebe neza aho imitsi yafunzwe.
- Tanga urutonde rw'imiti yose n'inyongeramusaruro ukoresha.
- Imiti nka aspirine ishobora gutangwa kugira ngo hirindwe kubyimba kw'amaraso.
- Irinde kurya cyangwa kunywa (byihuta) amasaha make mbere yo kubagwa.
Kubagwa bikorwa gute? Intambwe ku yindi
Ubusanzwe ubu buvuzi bumara amasaha ari munsi y’abiri kandi bukorwa n’itsinda ry’abaganga bahuguwe byihariye.
| Intambwe | Ni iki kiri kuba? |
|---|---|
| 1. Anesthesia | Akenshi uzaterwa ikinya burundu. Ushobora kandi guhabwa umuti muto wo kugutuza mu gihe uri maso. |
| 2. Gushyiramo katheteri | Umuyoboro wihariye (catheter) unyuzwa mu mwobo muto ukozwe mu kibuno ukagera ku mutsi wa carotide uri mu ijosi hifashishijwe imirasire ya X-ray. |
| 3. Gushyiramo akayunguruzo | Akayunguruzo gato gashyirwa inyuma gato y'aho kazibye kugira ngo gafate plaque iyo ari yo yose ishobora gucika mu gihe imitsi y'amaraso irimo kwaguka. Ibi bigabanya ibyago byo kurwara indwara yo gucika kw'imitsi. |
| 4. Gukoresha umupira w'amapine | Agapira gato gashyirwa mu gice cyo kuziba hanyuma kakabyimba, gashyiramo ibinure ku rukuta rw'imitsi maze kagakura umutsi. Hanyuma agapira karakurwaho. |
| 5. Gushyira stent | Ubu, stent yiyongera ubwayo mu gace kagutse. Ibi bifasha imitsi kuguma ifunguye. |
| 6. Kurangiza | Akayunguruzo na katheteri birakurwaho, maze umwobo wo mu kibuno ugafungwa hakoreshejwe igikoresho cyihariye. |
Bigenda bite nyuma yo kubagwa?
Nyuma yo kubagwa, uzakurikiranwa mu cyumba cyo gukira amasaha menshi. Ubusanzwe ugomba kurara mu bitaro ijoro ryose.
- Uzahabwa imiti igabanya ububabare iyo ari yo yose ushobora kugira.
- Muganga wawe azagutegeka gufata imiti igabanya ubukana bw'imitsi (urugero: Aspirine, Clopidogrel) ubuzima bwawe bwose kugira ngo wirinde ko amaraso afungana aho stent yashyizwe.
Abantu benshi bashobora gutaha bavuye mu bitaro nyuma y'amasaha 24. Hashobora kubaho ibisebe, kubyimba, n'ububabare buke aho bateye mu gihe cy'iminsi mike.
Ni izihe nyungu n'ingaruka z'ubu buvuzi?
Ibyiza
- Kugabanuka k'ibyago byo kurwara indwara yo mu bwonko: Uko amaraso agenda mu bwonko agaruka, ibyago byo kurwara indwara yo mu bwonko biragabanuka cyane.
- Gukata gato: Nta gukata gukomeye gukabije, bityo ububabare buragabanuka, ibyago byo kwandura, n'inkovu biragabanuka.
- Gukira vuba: Ushobora gusubira mu mirimo isanzwe mu minsi mike.
Ingaruka
Nkuko bigenda mu kubagwa kose, hari ingaruka nke, ariko ibyago byo kugira ingorane zikomeye biri munsi ya 3%.
- Restenosis: Ni gake cyane, inkovu zishobora kwirema munsi y'umuyoboro w'amaraso hanyuma zigafunga imitsi.
- Gucika kw'imitsi: Mu gihe cyo kubagwa, ibice by'ibinure bishobora gucika no kuziba imitsi yo mu bwonko. Ariko, ibi byago bigabanuka cyane bitewe n'akayunguruzo twavuze mbere.
- Indwara y'umutima
- Kuva amaraso cyangwa kwandura indwara
Ni ryari ugomba kujya kwa muganga?
Niba ubonye kimwe muri ibi bimenyetso iyo ugiye mu rugo nyuma yo kubagwa , hamagara muganga wawe ako kanya.
- Niba wumva ufite umuriro cyangwa ufite ibicurane
- Niba isesemi no kuruka birangiye
- Niba aho hakozwe isuku hatukura, habyimbye, cyangwa hakavamo amazi y'umuhondo (ibimenyetso by'ubwandu)
Icy'ingenzi kurushaho: Niba ubonye ibimenyetso bya stroke, nko kuvuga nabi, intege nke ku ruhande rumwe rw'umubiri, gucika intege mu maso, cyangwa impinduka mu byo ubona, jya ku bitaro byita ku butabazi bwihuse (ETU) vuba vuba.
Ubutumwa bwo kujyana mu rugo
- TFCAS ni uburyo bugezweho kandi budakoresha imbaraga nyinshi bukoreshwa mu gufungura imitsi yazibye mu ijosi no kugabanya ibyago byo kurwara indwara yo gucika kw'imitsi.
- Ubu buryo bwo kuvura ntibukwiriye buri wese. Ganira na muganga wawe uburyo bwo kuvura bukubereye.
- Ni ingenzi cyane kugira ubuzima bwiza (indyo nziza, imyitozo ngororamubiri, no kureka kunywa itabi) no gufata imiti wanditswe na muganga nkuko wanditswe nyuma yo kubagwa.
- Kumenya ibimenyetso bishobora kugufasha nyuma yo kubagwa, cyane cyane ibimenyetso by'indwara yo mu bwonko, bishobora kugufasha kurokora ubuzima bwawe.
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