Ni iki Angioplasty na Stenting ya Carotid? Intego, Uburyo & Ibivamo

Angioplasty na stenting ya carotid ni uburyo butagira ingaruka nyinshi bufungura imitsi ya carotid yazibye mu ijosi ryawe kugira ngo yongere amaraso mu bwonko bwawe. Tekereza nk'uko warema inzira isobanutse y'amaraso kugira ngo agere mu bwonko bwawe igihe umuhanda nyamukuru wagutse mu buryo buteye ubwoba.

Imitsi yawe ya carotid isa n'imihanda y'ingenzi itwara amaraso yuzuye umwuka wa oxygen ava mu mutima wawe ajya mu bwonko bwawe. Iyo iyi mitsi yazibye na plaque, bishobora gutera sitiroki cyangwa ibibazo bikomeye. Ubu buryo bufasha kwirinda ibyo bintu biteye ubuzima bw'akaga binyuze mu kugumisha ubwonko bwawe butunganyirijwe neza amaraso.

Ni iki angioplasty na stenting ya carotid ari cyo?

Angioplasty na stenting ya carotid bihuza uburyo bubiri bwo kuvura imitsi ya carotid yazibye. Mugihe cya angioplasty, muganga wawe azamura agahuhura gato imbere y'umutsi wagabanutse kugira ngo asunike plaque ku nkuta z'umutsi.

Igice cya stenting kirimo gushyiraho urwungano ruto rw'urushinge rwitwa stent kugira ngo rukomeze umutsi ufunguye burundu. Uru rushinge rumeze nk'urukuta, rushyigikira inkuta z'imitsi kandi rukarinda ko zongera kugabanuka.

Uburyo bwose bukorwa binyuze mu gukomeretsa gato mu gatuza kawe cyangwa ikibuno, kimwe n'uko catheterization y'umutima ikora. Muganga wawe ayobora imiyoboro mito, yoroshye binyuze mu miyoboro yawe y'amaraso kugira ngo agere ku mutsi wa carotid wazibye mu ijosi ryawe.

Kuki angioplasty na stenting ya carotid bikorwa?

Ubu buryo ahanini bukorwa kugira ngo birinde sitiroki igihe imitsi yawe ya carotid yazibye cyane. Imitsi yawe ya carotid itanga hafi 80% by'amaraso ajya mu bwonko bwawe, bityo kuziba gukwe gushobora kuba akaga.

Muganga wawe ashobora kugusaba ubu buryo niba ufite indwara ikomeye y'umutsi wa carotid, mubisanzwe iyo kuziba kuri 70% cyangwa kurenza. Nanone bitekerezwa iyo ufite ibimenyetso nka mini-sitroki cyangwa niba uri mu kaga gakomeye ko kubagwa.

Rimwe na rimwe, abaganga bahitamo ubu buryo kurusha kubaga gakondo ya carotid iyo ufite izindi ndwara zigutera ingorane zo kubagwa. Izi zirimo indwara z'umutima, ibibazo by'ibihaha, cyangwa niba warabazwe mu ijosi mbere cyangwa warahabwa imirasire.

Ni iki gikorwa cya carotid angioplasty na stenting?

Iki gikorwa gikunze gufata isaha imwe cyangwa ebyiri kandi gikorerwa mu cyumba cyihariye cyitwa laboratoire ya catheterization. Uzaba uri maso ariko urimo guhumurizwa, bityo uzumva uruhutse kandi umeze neza muri iki gikorwa.

Itsinda ryawe ry'abaganga rizakurikiza izi ntambwe zitunganye kugirango zizere ko ufite umutekano:

1. Umutoboro muto ukorwa mu mitsi yawe yo mu gatuza cyangwa mu kuboko
2. Urugo ruto rworoshye rwitwa catheter ruyoborwa mu mitsi yawe y'amaraso rugana ku mitsi ya carotid yazibye
3. Igikoresho cyo kurengera gishyirwa inyuma y'inzitizi kugirango gifate ibice byose
4. Baluni irahaguruka imbere mu nzitizi kugirango ifungure umutsi
5. Stent ishyirwaho kugirango ikomeze gufungura umutsi burundu
6. Igikoresho cyo kurengera na catheter bikurwaho

Igikoresho cyo kurengera ni ingenzi kuko gikora nk'igicucu gito, gifata ibice byose bya plaque bishobora gucika muri iki gikorwa. Ibi birinda ko ibice bigenda mu bwonko bwawe bigatuma ugira sitiroki.

Abantu benshi barashobora gutaha uwo munsi cyangwa nyuma yo kurara ijoro rimwe. Uzasuzumwa neza muri iki gikorwa no nyuma yacyo kugirango hamenyekane ko byose bigenda neza.

Ni gute wakwitegura carotid angioplasty na stenting yawe?

Kwitegura iki gikorwa bikubiyemo intambwe nyinshi zingenzi zifasha kumenya umutekano wawe n'ubushobozi bwawe. Muganga wawe azatanga amabwiriza yihariye ashingiye ku byo ukeneye ku buzima bwawe.

Ibi nibyo ushobora kwitega mumasaha mbere y'iki gikorwa:

• Hagarika imiti imwe nka ya ifasha amaraso gushyirwa mu buryo nk'uko byategetswe na muganga wawe
• Teganya umuntu uzagutwara nyuma y'igikorwa
• Ntukarye cyangwa unywe ikintu icyo aricyo cyose nyuma ya saa sita z'ijoro mbere y'igikorwa cyawe
• Fata imiti wandikiwe ufashishije amazi makeya niba ubitegetswe
• Menyesha muganga wawe ibijyanye n'uburwayi bwose, cyane cyane ku ifu ikoreshwa mu kugaragaza ibice by'umubiri cyangwa iodine
• Menyesha ikipe yawe y'ubuvuzi ibijyanye n'ibimenyetso byose by'ibicurane, grip, cyangwa umuriro

Muganga wawe ashobora kandi gutegura ibizamini mbere y'igikorwa nk'ibizamini by'amaraso cyangwa ibizamini by'amashusho. Ibi bifasha ikipe yawe y'ubuvuzi gutegura uburyo bwizewe cyane ku miterere yawe yihariye.

Bisanzwe rwose kumva ufite impungenge mbere y'igikorwa. Ntukazuyaze kubaza muganga wawe cyangwa umuforomo ibibazo byose ufite ku byo witegura.

Ni gute usoma ibisubizo byawe bya carotid angioplasty na stenting?

Intsinzi y'igikorwa cyawe ipimwa n'uburyo amaraso agaruka neza mu bwonko bwawe. Muganga wawe azakoresha ibizamini by'amashusho mu gihe cy'igikorwa no nyuma yacyo kugirango asuzume ibisubizo.

Nyuma y'igikorwa ako kanya, muganga wawe azagenzura ko stent ishyizwe neza kandi umutsi ukinguye. Ibisubizo byiza mubisanzwe bigaragaza umutsi ufunguye hafi y'ubugari bwawo busanzwe hamwe n'imikorere y'amaraso itunganye.

Amashusho akurikira mu mezi make azagenzura uburyo stent ikomeza gukora neza. Muganga wawe azashaka ibimenyetso byose by'umutsi wongera kugabanuka, ibyo bibaho mu byerekeye 5-10% by'imanza.

Uzagenzurwa kandi ibijyanye n'ibimenyetso by'imitsi kugirango wemeze ko ubwonko bwawe buri kubona amaraso ahagije. Abantu benshi bahura n'ibimenyetso byateye imbere cyangwa bihamye nyuma yo gukora stenting neza.

Ni iki gisubizo cyiza kuri carotid angioplasty na stenting?

Igisubizo cyiza ni ukugarura burundu imikorere y'amaraso binyuze mu mutsi wawe wa carotid nta ngorane. Ibi bivuze ko ubwonko bwawe buhabwa umwuka wa oxygen n'intungamubiri zihagije, bigabanya cyane ibyago byawe byo guhura n'indwara ya stroke.

Urwego rwo gukora neza kuri ubu buryo burashimishije cyane, aho intsinzi mu bya tekiniki igerwaho mu birenga 95% by'imanza. Abantu benshi bagira impinduka nziza mu bimenyetso byabo cyangwa bakirinda indwara zizaza ziterwa no gufatwa n'umutsi.

Ibyiza by'ingenzi birimo kandi imikorere myiza ya stent mu gihe kirekire. Ubushakashatsi bwerekana ko stent nyinshi ziguma zifunguye kandi zikora neza mu myaka myinshi, aho urugero rwo kongera gufungana ruguma hasi.

Usibye intsinzi mu bya tekiniki, umusaruro mwiza usobanura ko ushobora gusubira mu bikorwa byawe bisanzwe wizeye, uzi ko ibyago byo gufatwa n'umutsi byagabanutse cyane.

Ni ibihe bintu byongera ibyago byo gukenera carotid angioplasty na stenting?

Ibintu byinshi bishobora kongera amahirwe yawe yo kurwara indwara ya carotid artery ishobora gusaba ubu buryo. Kumva ibyo bintu byongera ibyago bishobora kugufasha gukorana na muganga wawe ku ngamba zo kwirinda.

Ibintu bisanzwe byongera ibyago bituma carotid artery ifungana birimo:

• Imyaka irenga 65, kuko imitsi isanzwe itangira kwiyongera ibyago byo kwegeranya plaque
• Umubyigano mwinshi w'amaraso wangiza imitsi mu gihe
• Urugero rwo hejuru rwa cholesterol rutuma plaque ikorwa
• Uburwayi bwa diyabete, butuma atherosclerosis yihuta
• Umunyonga, wangiza imitsi y'amaraso kandi ugatuma amaraso avurirana
• Amateka y'umuryango y'indwara yo gufatwa n'umutsi cyangwa indwara ya cardiovascular
• Umubyibuho ukabije no kutagira imyitozo ngororamubiri
• Umutima wigeze guhagarara cyangwa indwara ya peripheral artery

Ibintu bimwe byongera ibyago nk'imyaka na genetike ntibishobora guhinduka, ariko ibindi byinshi bishobora gucungwa hakoreshejwe impinduka mu mibereho no kuvurwa mu buvuzi. Muganga wawe ashobora kugufasha gukora gahunda yo gukemura ibintu byongera ibyago bishobora guhinduka.

Kugira ibintu byinshi byongera ibyago byongera cyane amahirwe yawe yo kurwara indwara ya carotid artery. Ariko, ndetse n'abantu bafite ibintu byinshi byongera ibyago bashobora kungukirwa n'ingamba zo kwirinda.

Ese ni byiza gukora carotid angioplasty na stenting cyangwa kubagwa?

Guhitamo hagati ya carotid angioplasty na stenting cyangwa kubaga gakondo kwa carotid biterwa n'uko ubuzima bwawe bwifashe n'ibintu bigushyira mu kaga. Uburyo bwombi bugira akamaro mu gukumira sitiroko, ariko buri kimwe gifite inyungu mu bihe bitandukanye.

Carotid angioplasty na stenting bishobora kuba byiza kuri wowe niba ufite ibyago byinshi byo kubagwa bitewe n'izindi ndwara. Ibi birimo indwara z'umutima, ibibazo by'ibihaha, cyangwa niba warabazwe mu ijosi mbere cyangwa warahabwa radiyo.

Kubaga gakondo kwa carotid bishobora gukundwa niba ukiri muto, ufite imiterere igoye ya plaque, cyangwa ufite imiterere ituma stenting bigoye mu buryo bwa tekiniki. Kubaga kandi bifite amakuru y'igihe kirekire agaragaza ubudahangarwa bwiza.

Muganga wawe azatekereza ibintu nk'imyaka yawe, ubuzima muri rusange, imiterere yawe, n'imiterere y'inzitizi yawe mugihe atanga iyi nama. Intego ni ukuguhitiramo uburyo bwizewe kandi bufite akamaro kurusha ubundi kubera uko ubuzima bwawe bwifashe.

Ni izihe ngaruka zishobora guterwa na carotid angioplasty na stenting?

Nubwo carotid angioplasty na stenting muri rusange bifite umutekano, kimwe n'ubundi buryo bwo kuvura, bifite ibyago bimwe. Kumva izi ngaruka zishobora gutuma ufata icyemezo gifitiye akamaro hamwe na muganga wawe.

Ingaruka zikomeye ariko zitabaho cyane zirimo:

• Sitiroko mugihe cyangwa nyuma gato y'uburyo (bibaho muri 2-4% by'ibihe)
• Umutima watewe n'umuvuduko w'uburyo
• Kuva amaraso ahantu hashyizweho catheter
• Kugira allergie ku ruvange rukoreshwa mugihe cyo gushushanya
• Ibibazo by'impyiko biturutse ku ruvange
• Amabara y'amaraso akora kuri stent
• Artery iraturika cyangwa igasenyuka (ntibibaho cyane)
• Udukoko ahantu hakomeretse

Ingaruka nyinshi ni iz'igihe gito kandi zishobora gucungwa neza n'ikipe yawe y'ubuvuzi. Ingaruka zikomeye ntizisanzwe, zibaho muri 5% by'uburyo.

Muganga wawe azakoresha ingamba nyinshi zo kugabanya ibyo byago, harimo gukoresha ibikoresho birinda no kugukurikiranira hafi mu gihe cyose cyo kuvurwa. Inyungu zo kwirinda sitiroke mubisanzwe ziruta ibyo byago kubarwayi benshi.

Ni ryari nkwiriye kubona muganga kubera ibibazo by'imitsi ya karotide?

Ugomba guhita uvugana na muganga wawe ako kanya niba ubonye ibimenyetso byose bishobora kugaragaza ibibazo by'imitsi ya karotide cyangwa ingaruka nyuma yo kuvurwa. Kumenya no kuvura ibyo bimenyetso hakiri kare birashobora kwirinda ingaruka zikomeye.

Shaka ubufasha bwihuse bw'ubuvuzi niba ubonye ibi bimenyetso byo kwitondera:

• Kugabanuka kw'imbaraga cyangwa ububabare mu maso yawe, ukuboko, cyangwa ukuguru, cyane cyane ku ruhande rumwe
• Urujijo rutunguranye cyangwa ingorane zo kuvuga cyangwa gusobanukirwa ijambo
• Ibibazo by'amaso bitunguranye mu jisho rimwe cyangwa yombi
• Umutwe utunguranye ukabije nta mpamvu izwi
• Ingorane zitunguranye zo kugenda, isereri, cyangwa kutagira uburinganire
• Ibihe by'agateganyo by'ibi bimenyetso (mini-sitrokes cyangwa TIAs)

Nyuma yo kuvurwa, ugomba kandi kuvugana na muganga wawe niba ubonye amaraso, kubyimba, cyangwa ububabare budasanzwe ahaciwe. Ibi bishobora kugaragaza ingorane zikeneye kuvurwa vuba.

Ibiganiro bisanzwe byo gukurikirana ni ngombwa nubwo wumva umeze neza. Muganga wawe azakurikirana stent yawe n'ubuzima bw'imitsi ya karotide muri rusange kugirango yemeze intsinzi irambye.

Ibikunze kubazwa kuri karotide angioplasty na stenting

Q.1 Ese karotide angioplasty na stenting ni byiza mu kwirinda sitiroke?

Yego, karotide angioplasty na stenting bifite akamaro kanini mu kwirinda sitiroke kubantu bafite imitsi ya karotide ifunze cyane. Ubushakashatsi bwerekana ko bigabanya ibyago bya sitiroke nka 70-80% ugereranije no kuvurwa gusa.

Ubu buryo bufitiye akamaro kanini abantu bafite ibiziba bya 70% cyangwa barenzeho, cyangwa abamaze kugira utuvungura duto. Bukora mu gusubiza amaraso mu buryo busanzwe mu bwonko bwawe no gukumira ibishishwa byo gucikagurika no gutera indwara zikomeye.

Q.2 Ese kugira carotid stent bitera ibibazo by'igihe kirekire?

Abantu benshi bafite carotid stents babaho ubuzima busanzwe, bwiza nta bibazo bikomeye by'igihe kirekire. Stent iba igice cy'iteka ry'umutsi wawe, kandi umubiri wawe ubusanzwe urabyakira neza.

Uzaba ukeneye gufata imiti igabanya amaraso mu gihe gito nyuma y'uburyo, kandi uzajya ukurikiranwa buri gihe kugira ngo urebe uko stent ihagaze. Abantu bamwe bashobora guhura no kongera kugabanuka kw'umutsi uko igihe kigenda, ariko ibi ntibisanzwe kandi mubisanzwe birashobora kuvurwa niba bibaye.

Q.3 Bifata igihe kingana iki kugira ngo ukire carotid angioplasty na stenting?

Kuvura carotid angioplasty na stenting mubisanzwe birihuta cyane kuruta kuvura kubagwa kwa carotid gakondo. Abantu benshi barashobora gusubira mu bikorwa bisanzwe mu minsi mike kugeza ku cyumweru.

Uzaba ukeneye kwirinda kuzamura ibintu biremereye mu gihe cy'icyumweru kandi ukore gahoro mu minsi mike ya mbere. Ahantu hakomeretse mu gatuza kawe cyangwa mu kuboko mubisanzwe hakira mu minsi mike, kandi mubisanzwe urashobora gutwara imodoka mu munsi umwe cyangwa ibiri niba utafata imiti ikomeye yo kurwanya ububabare.

Q.4 Ese nkeneye gufata imiti nyuma ya carotid stenting?

Yego, uzaba ukeneye gufata imiti yihariye nyuma ya carotid stenting kugira ngo wirinde amaraso gukora ku stent yawe. Ibi mubisanzwe bikubiyemo aspirine n'indi miti irwanya platelet nka clopidogrel.

Muganga wawe ashobora kandi gutegeka imiti yo gucunga ibintu bigushyira mu kaga, nk'imiti igabanya umuvuduko w'amaraso, imiti igabanya cholesterol, n'imiti ya diyabete niba bikenewe. Iyi miti ni ingenzi mu gukumira ibibazo by'imitsi y'umutima mu gihe kizaza.

Q.5 Ese ibiziba by'imitsi ya carotid bishobora kugaruka nyuma ya stenting?

Nubwo bishoboka ko inzira y'amaraso yongera kuziba nyuma yo gushyirwamo icyuma, ntibisanzwe. Kongera kugabanuka (byitwa restenosis) bibaho mu byegeranyo biri hagati ya 5-10%, akenshi mu mwaka wa mbere nyuma y'uburyo bwakoreshejwe.

Niba kongera kugabanuka bibayeho, akenshi bishobora kuvurwa hakoreshejwe ubundi buryo bwa angioplasty. Gukurikiza inama za muganga wawe ku bijyanye n'imiti, impinduka mu mibereho, no kugenzura buri gihe bishobora gufasha kugabanya ibyago byo kongera kuziba kw'inzira y'amaraso.