Angioplasty-inonziwo "percutaneous transluminal coronary angioplasty," kana kuti PTCA-inzira yekugadzirisa zvinokonzera kubvisa zvivharo mukati memaatri, kakawanda mumaketari e coronary .
Angioplasty inoshanda nekupinza bharuti duku mukati meyeri panzvimbo yeatrosclerotic plaque , kuisa pasi pavhara uye kuderedza stenosis (kuvhara) mukati meyeri.
Munenge mumiririro ose angioplasty inowanikwa nekuiswa kwe stent .
Maitiro Angioplasty Anoitwa Sei?
Kuti aite angioplasty, chiremba anoshandisa catheter (yakareba, yakaonda, inogadziriswa pipe) iyo ine bhaluni yakasvibiswa yakaiswa pairi. Iyo catheter inopfuura napamusoro pemucheka uri kuunza kuvhara, uye ibhaluni inonzwisiswa pasi pekumanikidza. Kuwedzerwa kwebhaluni kunomesa chikwangwani pamusvingo we arteri. Apo bhovhoni yakasvibiswa uye yakabviswa, iyo bhokisi inoramba iine chikamu chakaomesa, saka kuvhara kunopera.
Kunyange zvazvo angioplasty yakatanga kuitwa semirairo yekumira-yoga, nhasi inonzi stent inowanikwawo pose apo angioplasty inoshandiswa pamutambo wegononi. Nhengo inowedzera "scaffold" iyo inobatsira kutsigira rusvingo rwetari panzvimbo ye angioplasty, kuitira kuchengetedza chikwangwani chakaomerera. Iyo stent inoputsika inoiswa pamusoro pebhoti isati yaiswa.
Zvadaro, apo bhovhoni ikakonzerwa, chidimbu chacho chinomanikidzwa uye iyo stent inowedzera panguva imwe chete. Apo bhoron racho rinosvibiswa uye rinobviswa, iyo stent inosara munzvimbo, ichibatsira kuchengeta chidimbu chakaomesa uye ariti yakazaruka.
Apo Inobatsira
Angioplasty inoshanda chaizvo mukuderedza zviratidzo zvekuchengetedza angina .
Saka chikonzero chikuru chekuita angioplasty mune artery coronary ndechokubata angina iyo inoramba iripo pasinei nekuedza kwerapi yezvechiremba. Kunyange zvazvo zvingaita sezvisingashamisi kune vakawanda, angioplasty (kunyange kana stent inowanikwa) haina kuratidzirwa kuti inoshanda kupfuura mushonga werapi mukuderedza dambudziko rinotevera remyocardial infarction (kurwisa kwemoyo), kana kuti kuvandudza kupona. Saka chikonzero chikuru chekuita angioplasty ndechokubvisa angina yakagadzikana yakaramba iripo pasinei nekuedza kuigadzira mishonga.
Chikonzero chechipiri chinonzi angioplasty (uye chinokanganisa) chinowanzoshandiswa mukurapa chirwere chetachiona chirwere chiri kuvanhu vane acon coronary syndrome (ACS). MuAACS, kuvharwa kwakanyanya kwegoniyoni yakaitika nokuti bhokisi rakaputika uye chipfeko chakaumbwa mukati meyeri. Apo ACS iri kuitika, chirwere chemwoyo chinowanzoitika kunze kwekuti chironga chikazarurwa. Munguva yeAACS, uchapupu hunowanikwa hunoratidza kuti angioplasty uye kushivirira kunogona kubatsira zvakanyanya kugadzirisa zvibereko zvemoyo.
I-coronary arteries haisi iyo mishonga chete iyo angioplasty inowanzoshandiswa kurapa mabstructive atherosclerotic plaques. Angioplasty inoshandiswawo kumaketari e-carotid (ayo anopa uropi), maitiro emvura (iyo inopa mafyvo) uye mitsipa yemakumbo.
Matambudziko
Dambudziko rinowanzoitika rinotevera angioplasty roga ndiro restenosis - kuumbwa kwechigadziro chitsva panzvimbo yekambani yakanyanyiswa. Restenosis inoratidzika kupedzisira kunokonzerwa nekukura kwechigunwe-zvichida mukugadzirisa dambudziko rinogadzirwa mukati uye rakakomberedza rusvingo rwomukati nema angioplasty pacharo. Chiitiko chekuzorodza chakave chakanyanya kuderedzwa nekushandiswa kwemasero, kunyanya zvinodhaka-eluting stents (DES), izvo zvakaputirwa nemishonga inodzivisa kukura kwezviviri, zvichiita kuti kuderedza kupora.
Pamberi penguva yemazino, kuchema kwekupedzisira kwakaitika munenge makumi matatu kubva muzana yevarwere vakanga vane angioplasty voga.
Kushandiswa kwesimbi isina simba yakaderedza iyi ngozi kusvika pasi pe15%, uye zvinodhaka-eluting stents zvakaderedza zvishoma kusvika 10%.
Dambudziko rinowanzoita, asi rinoparadza zvikuru, ishuvhusis (ropa clotting) panzvimbo ye angioplasty / stenting. Kugadzikana kwakanyanya kunowanzoitika uye kamwe kazhinji kunoparadza, izvo zvinowanzoita kuvhiringidza kwakakwana uye kwakakwana kwechigunha chakakanganiswa. Thrombosis inonyanya kuonekwa munguva pfupi mushure mokunge chirongwa chengioplasty (kureva, mukati memazuva kusvika kumavhiki). Zvisinei, apo stent yakaiswa munguva yengirozi (iyo inenge iri nguva dzose nhasi), pangozi yakanyanya ye thrombosis inopfuurira kwemwedzi inoverengeka kusvika makore akawanda mushure mekuita. Ngozi yeprombosis yakaderedzwa zvakanyanya nekushandiswa kwema anti-platelet drugs -izvo, zvisinei, zvinotakurawo ngozi.
Zvimwe zvinetso zvinogona kuitika munguva yengirozi zvinosanganisira kukanganisa kwomuviri unowanikwa neropa remvura rinotapurirwa (kusanganisira mwoyo, kurwisa kwepvo kana kurohwa), chironga chemwoyo, kana kubuda ropa.
Verenga zvakawanda pamusoro pezvose zvinoshandiswa pakushandiswa kwekodonary artery chirwere .
> Sources:
> Vanyori / Task Force nhengo, Windecker S, Kolh P, et al. 2014 ESC / EACTS Mirayiridzo pamusoro peMyocardial Revascularization: The Task Force pamusoro peMyocardial Revascularization yeEuropean Society of Cardiology (ESC) uye European Association yeCardio-Thoracic Surgery (EACTS) Yakagadzirwa nemupiro unokosha weEuropean Association of Percutaneous Cardiovascular Interventions ( EAPCI). Eur Moyo J 2014; 35: 2541.
> Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC / AHA / AATS / PCNA / SCAI / STS Inotsanangurwa Kuvandudzwa kweMutungamiri weKutsvaga uye Kutarirwa Kwevarwere vane Stable Ischemic Heart Disease: Nyaya yeAmerican College of Cardiology / American Heart Association Task Force pamusoro Pemitemo Yezvokuita, uye American Association for Chipatracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, uye Society of Thoracic Surgeons. J Am Coll Cardiol 2014; 64: 1929.