Angioplasty thiab stent tso kawm - carotid leeg

Cov hlab ntshav uas nqa ntshav rau koj lub hlwb thiab lub ntsej muag yog hu ua cov hlab ntsha carotid. Koj muaj carotid leeg nyob rau txhua sab ntawm koj lub caj dab.

Cov ntshav ntws hauv cov hlab ntsha no tuaj yeem dhau los yog ib nrab lossis lig los ntawm cov khoom siv roj hu ua cov quav hniav. Qhov thaiv ib nrab yog hu ua carotid artery stenosis (nqaim). Qhov kev cuam tshuam hauv koj cov carotid artery tuaj yeem txo cov ntshav xa mus rau koj lub hlwb. Qee zaum qee qhov ntawm cov quav hniav tuaj yeem ua txhaum thiab thaiv lwm txoj leeg. Mob stroke yuav tshwm sim yog tias koj lub hlwb tsis tau ntshav txaus.

Ob txoj kev tuaj yeem siv los kho cov carotid leeg uas yog nqaim lossis txhaws. Cov no yog:

• Kev phais kom tshem tawm cov quav hniav buildup (endarterectomy)
• Carotid angioplasty nrog kev tso quav stent

Carotid angioplasty thiab stenting (CAS) ua tiav los siv kev txiav me me.

• Koj tus kws phais yuav txiav phais hauv koj puab tais tom qab siv qee cov tshuaj loog. Koj tseem yuav muab tshuaj rau koj los so kom txaus.
• Tus kws phais mob tso txoj raj yas (txoj raj xa pa) los ntawm kev txiav rau txoj leeg. Nws tau ua tib zoo txav ntawm koj lub caj dab txhawm rau txhaws hauv koj cov carotid leeg. Tsiv duab xoo hluav taws xob (duab fluoroscopy) yog siv los pom cov leeg ntshav thiab coj cov raj ntsuas dej kom yog rau txoj haujlwm tseeb.
• Tom ntej no, kws phais yuav txav cov hlau los ntawm txoj raj rau txoj kev txhaws. Lwm txoj raj yas uas muaj lub pob zais me me rau ntawm qhov kawg yuav raug thawb ntawm cov hlau no thiab mus rau hauv qhov tsis sib thooj. Tom qab ntawd lub zais zais pa.
• Lub zais pa nias tawm tsam sab hauv phab ntsa ntawm koj cov leeg. Qhov no qhib cov leeg thiab tso ntshav ntxiv rau koj lub hlwb. Lub stent (ib txoj hlua hluav taws xob tsis xaim hlau) kuj tseem yuav raug tso rau hauv thaj chaw thaiv. Lub stent yog ntxig rau tib lub sijhawm uas muaj lub tshuab ntsuas pa. Nws nthuav nrog lub zais pa. Lub stent raug sab laug rau hauv qhov chaw txhawm rau pab ua kom cov leeg ntshav.
• Tus kws phais mob tshem tawm cov zais zais.

Kev phais mob Carotid (endarterectomy) yog txoj kev laus dua thiab siv tau los kho txoj kev nqaim lossis thaiv cov hlab ntsha. Tus txheej txheem no nyab xeeb heev.

CAS tau tsim los ua cov qauv zoo rau kev phais mob, thaum ua los ntawm cov neeg ua haujlwm paub txog. Qee yam yuav ua rau stenting, xws li:

• Tus neeg mob dhau lawm kom tsis muaj carotid endarterectomy.
• Qhov chaw ntawm txoj kev nqaim hauv carotid leeg ua rau kev phais sib tw.
• Tus neeg tau mob caj dab lossis carotid phais neeg yav dhau los.
• Tus neeg tau hluav taws xob rau lub caj dab.

Kev phom sij ntawm cov kab mob carotid angioplasty thiab stent qhov tso kawm, uas nyob ntawm ntau yam xws li hnub nyoog, yog:

• Kev tsis haum cov zas
• Cov ntshav txhaws lossis ntshav ntxiv rau ntawm thaj chaw phais
• Lub hlwb puas tsuaj
• Clogging sab hauv ntawm lub stent (hauv-stent restenosis)
• Plawv nres
• Raum lub raum (muaj kev pheej hmoo siab dua rau cov neeg uas twb muaj teeb meem raum)
• Ntau qhov txhaws ntawm cov carotid leeg thaum lub sijhawm
• Mob chua leeg (qhov no tsis tshua muaj)
• Mob stroke

Koj tus kws kho mob yuav kuaj mob lub cev thiab ua ntau yam kev kuaj mob.

Qhia koj tus kws khomob paub txhua yam tshuaj uas koj noj, suav nrog tshuaj, tshuaj noj, lossis tshuaj ntsuab uas koj tau yuav yam tsis tau xaj tshuaj.

Lub sijhawm 2 lub lis piam ua ntej koj cov txheej txheem:

• Hnub ua ntej kev phais mob, koj yuav tsum tsum tsis noj cov tshuaj uas ua rau koj cov ntshav txhaws nyuaj. Cov no suav nrog cov tshuaj aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient) naprosyn (Aleve, Naproxen), thiab lwm yam tshuaj zoo li cov no.
• Nug koj tus kws kho mob seb koj yuav tsum noj cov tshuaj hnub twg uas koj phais.
• Yog tias koj haus luam yeeb, koj yuav tsum nres. Nug koj tus kws kho mob kom pab txiav.
• Nco ntsoov qhia rau koj tus kws kho mob paub txog mob khaub thuas, khaub thuas, kub taub hau, mob pob txuv, lossis lwm yam mob uas koj yuav muaj ua ntej koj phais.

TSIS txhob haus ib yam dab tsi tom qab ib tag hmo hmo ua ntej koj txoj kev phais mob, suav nrog dej.

Hnub koj phais:

• Noj cov tshuaj uas koj tau hais kom noj nrog lub me pas dej.
• Luag yuav qhia rau koj paub thaum mus txog hauv tsev kho mob.

Tom qab phais mob, koj yuav tsum tau pw hauv tsev kho mob thaum hmo ntuj kom koj tuaj yeem soj ntsuam koj tus cim los ntshav, ntshav tawm, lossis ntshav khiav tsis txaus mus rau koj lub hlwb.Koj tuaj yeem mus tsev tib hnub yog tias koj txoj kev ua tiav ntxov thiab koj ua tau zoo. Koj tus kws khomob yuav nrog koj tham txog yuav tu koj li cas hauv tsev.

Carotid leeg txoj hlab ntsha angioplasty thiab stenting tuaj yeem pab txo koj txoj hmoo ntawm txoj hlab ntshav tawg. Tab sis koj yuav tsum tau hloov pauv txoj kev ua neej los pab tiv thaiv plaque buildup, ntshav txhaws, thiab lwm yam teeb meem hauv koj cov hlab ntsha carotid hauv lub sijhawm. Koj yuav tau pauv koj kev noj haus thiab pib ib ce muaj zog yog tias koj tus kws kho mob qhia koj ib ce muaj sia muaj kev nyab xeeb rau koj.

Carotid angioplasty thiab stenting; CAS; Angioplasty - carotid leeg; Carotid leeg leeg stenosis - angioplasty

• Angina - tawm hauv
• Angina - yuav tsum nug koj tus kws kho mob li cas
• Angina - thaum koj mob hauv siab
• Angioplasty thiab stent - lub siab - tso tawm
• Antiplatelet tshuaj - P2Y12 inhibitors
• Cov tshuaj aspirin thiab kab mob plawv
• Butter, margarine, thiab roj ua noj
• Cov roj khov thiab txoj kev ua neej
• Roj Cholesterol - tshuaj kho mob
• Tswj koj cov ntshav siab
• Kev noj haus cov rog piav qhia
• Cov lus qhia zaub mov nrawm
• Plawv nres - tso tawm
• Plawv nres - dab tsi yuav nug koj tus kws kho mob
• Kab mob hauv lub plawv - yam txaus ntshai
• Yuav nyeem daim ntawv zaub mov li cas
• Noj ntsev tsawg
• Mediterranean noj
• Kev phais mob kho mob - qhib

• Atherosclerosis ntawm carotid leeg o
• Carotid stenosis - X-ray ntawm txoj leeg leeg
• Cov roj khov tsim

Aboyans V, Ricco JB, Bartelink MEL, li al. Kev xaiv tus neeg xaiv - 2017 ESC cov lus qhia ntawm kev kuaj mob thiab kho mob ntawm cov leeg ntshav txhaws, koom tes nrog European Society rau Vascular phais (ESVS). Eur J Vasc Endovasc Surg. 2018; 55 (3): 305-368. PMID: 28851596 pubmed.ncbi.nlm.nih.gov/28851596/.

Brott TG, Halperin JL, Abbara S, li al. 2011 ASA / ACCF / AHA / AANN / AANS / ACR / ASNR / CNS / SAIP / SCAI / SIR / SNIS / SVM / SVS cov lus qhia txog kev tswj hwm cov neeg mob nrog mob ntxiv ntawm lub cev thiab lub pob txha caj qaum: cov ntaub ntawv tshaj tawm: tsab ntawv ceeb toom ntawm Asmeskas Lub Tsev Kawm Qib Siab ntawm Cardiology Foundation / American Heart Association Task Force ntawm Kev Coj Ua, thiab American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress ntawm Neurological Surgeons, Society of Atherosclerosis Kev Tshawb Xyuas thiab Tiv Thaiv, Lub Koom Haum Rau Kev Kho Mob Hlawv Mob Hlaus thiab Kev Tiv Thaiv, Lub Koom Haum ntawm Kev Tiv Thaiv Hluav Taws Xob, Lub Zej Zog ntawm NeuroInterventional Kev Kho Mob, Lub Koom Haum rau Vascular Tshuaj, thiab Lub Koom Haum Rau Kev Kho Vascular Tsim nyob rau hauv kev koom tes nrog American Academy ntawm Neurology thiab Society ntawm plawv plawv Computed Tomography. Catheter Cardiovasc Interv. 2013; 81 (1): E76-E123. PMID: 23281092 pubmed.ncbi.nlm.nih.gov/23281092/.

Brott TG, Howard G, Roubin GS, li al. Lub sij hawm ntev cov txiaj ntsig ntawm stenting tiv thaiv endarterectomy rau carotid-artery stenosis. N Engl J Med. 2016; 374 (11): 1021-1031. PMID: 26890472 pubmed.ncbi.nlm.nih.gov/26890472/.

Hicks CW, Malas MB. Cerebrovascular kab mob: carotid leeg leeg stenting. Hauv: Siavy AN, Perler BA, eds. Rutherford's Kev Kho Mob Ntshav Qab Zib thiab Kev Kho Mob Endovascular. 9le ed. Philadelphia, PA: Elsevier; 2019: chap 92.

Kinlay S, Bhatt DL. Kev kho mob ntawm noncoronary obstructive vascular kab mob. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: cha 66.

Rosenfield K, Matsumura JS, Chaturvedi S, li al. Randomized mus sib hais ntawm stent tiv thaiv kev phais rau asymptomatic carotid stenosis. N Engl J Med. 2016; 374 (11): 1011-1020. PMID: 26886419 pubmed.ncbi.nlm.nih.gov/26886419/.