Restenosis inoreva kuwedzera kuderedzwa kwechirwere chegoni pashure pokunge kubviswa kwave kuchibatwa ne angioplasty uye inopisa . Kana restenosis inowanzoitika, inowanzoitika mukati memwedzi 3 - 12 yekugadzirisa. Nokuti restenosis inokonzera kuti arteri iwedzere zvakare, zviratidzo zveanina zvinowanzodzoka.
Restenosis yakaonekwa sechinetso mumazuva chaiwo ekutanga eangioplasty, inowanikwa mune vazhinji vanoita 40 - 50% yevanhu vakabatwa ne angioplasty chete.
Kutaura zvazviri, chikonzero chekuti stents yakagadzirwa munzvimbo yekutanga kwaiva kuderedza kuitika kwekuzorora.
Kusvika pamwero mukuru, stents yakabudirira pakuita saizvozvo. Kunyange nechizvarwa chekutanga chesimbi isina simba (BMS), chiitiko che restenosis chakanyanya kuderedzwa (kusvika 20 kusvika ku30% mumwedzi 12). Zvadaro, madhiragi-eluting stents (DES) akaumbwa kuti aedze kuderedza restenosis kunyange zvakadaro. Mune DES, iyo stents yakafukidzwa nemishonga inoita kuti hutachiona huwedzere hunoendesa ku restenosis.
Chizvarwa chokutanga che DES chakaderedza chiitiko chekudzorerwa kusvika kune 15% pamakore mashanu. Zvitsva DES zvakaderedza huwandu hwekugara kwemareenosis, kunyange kusvika 5 kusvika ku7% pamakore mashanu.
Chii Chinokonzera Restenosis?
Angioplasty (uye stent placement, sezvo iyo nguva dzose inoperekedzwa ne angioplasty) inoratidziro rwechigunun'una. Penguva yengioplasty, catheter rinotakura ibhota rakasvibiswa rinopfuura nepasitorike ye- atherosclerotic mumutambo wegononi, uye ipapo ibhoti inogamuchirwa.
Kuwedzera kwebhaluni kunosimbisa chikwangwani, nokudaro kuwedzera kuzarura kwetari. Simba - chirongwa chechidimbu chiduku-chinowedzerwa panzvimbo yeAngioplasty, kuchengetedza arteri yakawedzerwa kubva pakundika zvakare. Kunyunyisa (kana kuti "smashing," kana iwe uchida) kwepakiti haisi kunyoroka, uye nguva dzose inogadzira kushungurudzika kune rimwe ropa remadziro.
Restenosis inoitika semugumisiro wekukura kwemavara panzvimbo yekurapa. Iyo inogona kunge yakangofungidzirwa semugumisiro we "kuporesa" nzira inotevera hutambudzi hwemangwana hwe angioplasty. Izvozvo zvinogadziriswa masero zvinowanzotanidza mishonga yecononary inowedzera panzvimbo yekutambudzika. Kana kupararira kwemasero endothelial kunowedzera, masero anogona kudzivisa ropa mumudziyo panzvimbo ye stent.
Restenosis inogonawo kuitika semugumisiro wenguva dzose inonzi atherosclerosis - iyo nzira yakakonzera kuti maronary artery ivhare mukutanga. Restenosis inokonzerwa ne atherosclerosis inowanzoonekwa sechinguva refu mushure mekuita-gore kana kupfuura. Izvo zvinowanzoitwa restenosis, iyo inowanzoonekwa mukati memwedzi mitanhatu uye inenge nguva dzose mukati memwedzi gumi nemaviri zvichienderana nekugadzirisa, inowanzonzerwa nekuguma kwemashutu ekukura.
Restenosis vs. Thrombosis
Restenosis haisi yakangofanana neyekutya kudengenyeka kwepisitiri - kukurumidza kusvibiswa kwe stent kubva pakuumbwa kweropa. Kushungurudzika kwakanyanya kunowanzova njodzi, sezvo inowanzobereka kuvhara nekukurumidza kweyoroni. Ngozi yeprombosis yakanyanya kupfuura mavhiki mashoma kana kuti mwedzi mushure mekugadziriswa, asi yakaderedzwa zvikuru nekushandiswa kweplatelet-inhibiting drugs .
Panewo dambudziko duku asi rechokwadi rekuguma kwe-stent thrombosis - thrombosis inoitika gore kana kupfuura mushure mekunge stent yaiswa - uye mumakore achangopfuura yakave yakajeka kuti mishonga inorwisa-platelet inofanirwa kupfuurirwa kwegore rimwechete uye inogona kunge yakareba . Nzira yakanakisisa yekudzivisa nguva yekupera kwepfusion, zvisinei, inoramba ichikakavadzana.
Restenosis Inobatwa Sei?
Kunyange zvazvo kushandiswa kwe DES kwakaderedza zvikuru chiitiko che stent restenosis, haina kubvisa dambudziko racho.
Kana restenosis ichiitika uye ichiratidza zviratidzo zve angina, kurapwa kunowanzobatanidza nzira yekudzokorora - kazhinji, kuiswa kwechipiri chetendi munzvimbo imwe chete.
Chiremba (noninvasive) chirwere chengina chinoshandiswawo. Chiremba cheCononary kuburikidza nekuvhiya ndeimwe nzira yevanhu vane stent restenosis, zvikuru kana kana restenosis inodzoka shure kwechipiri chetete.
Summary
Restenosis pakutanga ndiyo yakakosha pakushandisa angioplasty uye stents ye coronary artery disease. Sezvo inyanzvi yekombiki yakagadziriswa, restenosis ikozvino yakanga isinganyanyi kukosha sechinetso. Zvisinei, kushandiswa kwemazuva ano kwemazuva ano kwakaunza imwe dambudziko rekutungamirira kune kutarisirwa kwegononary arteri-stent thrombosis. Nzira yakanakisisa yekuderedza dambudziko redambudziko idzva ichiri kushandiswa.
> Sources:
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> Piccolo R, Stefanini GG, Franzone A, et al. Kuchengetedzwa uye Kubudirira kweSarolute Zotarolimus-kukwira Stents Kusiyana Ne Everolimus-Euting Stents: Meta-analysis. Circ Cardiovasc Interv 2015; 8.
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