Angioplasty-sidoo kale loo yaqaan "peronaneous coronary angioplasty," ama PTCA-waa habka katheterization ee loogu talagalay in lagu xakameeyo xannibaadaha halbowlayaasha halbowlayaasha, badanaaba halbowlayaasha wadnaha .
Isku-buufarka Angioplasty wuxuu ku shaqeeyaa baaldi yar oo gudaha halbowlaha ka jira goobta hareeraha atherosclerotic , xajmiga huurada iyo yaraynta xanuunka (xannibaadda) gudaha halbowlaha.
Xaalad kasta oo kiniiniga furuqa ah waxaa weheliya gelinta stent .
Sidee cudurka Angioplasty waa
Si loo sameeyo daawada angioplasty, dhakhtarku wuxuu isticmaalaa kateetar (tubo dheer, khafiif ah, tubbo dabacsan) kaas oo leh bakeeriye la jebiyey. Kateetarka waxaa lagu gudbiyaa huurada oo soo saaraysa xannibaadda, bacda ayaa lagu faafiyaa cadaadiska. Ballaarinta balloonku wuxuu ku daboolayaa huurada ka soo horjeeda derbiga xididka. Marka balaashadu la gooyo oo laga saaro, lakabadda ayaa weli ku yar tahay qayb ahaan, sidaas awgeed xannibaadda ayaa hoos loo dhigaa.
Inkastoo angioplasty markii hore asaas ahaan loo fuliyay nidaam gooni gooni ah, maanta muraayad ayaa lagu dhejiyaa mar kasta oo angioplasty lagu sameeyo halbowlaha wadnaha. Dareemku waa "ballaarid" ballaaran oo gacan ka geysanaya taageerida derbiga xididka halbowlaha ee goobta xuubka angioplasty, si loo ilaaliyo lakabka lagu xakameeyo. Goobta dillaacday waxaa la dhigayaa bakeeriga ka hor inta aan la gelin.
Kadib, marka bacda la gashado, huurada ayaa la fiiqay, isla markaana fiiqiisana waa la ballaariyay. Marka balaashadu dib loo dhigo oo laga saaro, duufaanka ayaa ka baxaya, isagoo ka caawinaya inuu hayo lakabka lafdhabarka ah iyo halbeegga furan.
Marka ay caawineyso
Angioplasty waa wax ku ool ah yaraynta calaamadaha ah angina xasilloon .
Sidaa daraadeed sababta ugu weyn ee loo sameynaayo wadno-qabadka dhiig-baxa ayaa ah daaweynta angina oo sii wadi doonta inkastoo isku dayga daweynta caafimaadka. Iyadoo laga yaabo inay u muuqato mid la yaab leh dad badan, xinjirrada jirka (xitaa marka la geliyo stent) looma muujinin inay ka fiican tahay daweynta daweynta ee yaraynta khatarta dambe ee xanuunka 'myocardial infarction' (heart attack), ama si loo hagaajiyo badbaadada. Sidaa daraadeed waa sababta ugu weyn ee looga hortago angioplasty waa in la yareeyo angina xasilloon oo sii waday inkastoo isku dayga lagu daaweeyo daaweyn ahaan.
Sababta labaad ee angioplasty (iyo stenting) waxaa badanaa loo isticmaalaa daaweynta cudurka loo yaqaan 'coronary artery disease' waxay ku dhacdaa dadka qaba xanuunka 'coronary syndrome' (ACS). ACS, xannuun ba'an oo ku dhaca halbowlaha halbowlaha ayaa ka dhacay sababtoo ah huuri ayaa dillaacday oo xinjir ayaa laga sameeyay gudaha halbowlaha. Marka ACS-du dhaco, wadne-qabadka wadnaha ayaa aad u dhicin haddii aan la furin. Inta lagu jiro ACS, caddaymaha la heli karo waxay muujinayaan in angioplasty iyo stenting ay gacan ka geysan karaan si wax ku ool ah si kor loogu qaado natiijooyinka guud ee wadnaha.
Halbowlayaasha halbowlaha ma aha halbowlaha kaliya ee cudurka angioplasty si joogta ah loo isticmaalo si loo daaweeyo jimicsiyada xididada ah ee atherosclerotic. Angioplasty sidoo kale waxaa lagu dabaqaa xididadaha carotid (kaas oo maskaxda siinaya), halbowleyaasha xaamilaha (oo bixiya kelyaha) iyo halbowlayaasha lugta.
Dhibaatooyinka
Dhibaatada ugu caansan ee ka timaada angioplasty keligaa waa restenosis - sameynta xirmo cusub oo ku taal goobta hargabka la jarjaray. Dib-u-qabashada ayaa ah hab tartiib tartiib ah oo ay sababtay kobaca cusub ee unugyada-laga yaabo in ay ka jawaabto dhaawacyada soo gaara gudaha iyo agagaarka derbiga markabka by angioplasty laftiisa. Cudurka dib-u-nasashada ayaa si aad ah u yaraatay isticmaalka stent, gaar ahaan stent-elemen stents (DES), kuwaas oo lagu daboolay daawo ka horjoogsanaya koritaanka unugyada, sidaas darteedna yareeya restenosis.
Ka hor wakhtigii stent, celceliskii restenosis wuxuu kudhacay qiyaastii 30% bukaannada qaba cudurka iskubaaxa oo keliya.
Isticmaalka mashiinnada birta ee qaawan waxay hoos u dhigtay khatartaas in ka yar 15%, iyo stent-dhibcaha stents waxay hoos u dhigtay in ka yar 10%.
Dhibaato aan caadi aheyn, laakiin halis daran, waa dhiig-xinjirowga dhiigga (dhiig-xinjirowga) goobta goobta angioplasty / stenting. Xinjir dhiig-xinjirowga ah waa dhacdo lama filaan ah oo inta badan dhacda, taas oo caadi ahaan soo saartey xannibaad buuxda oo dhammeystiran oo ka yimaada halbowlaha. Dhiig-xinjirowga waxaa sida caadiga ah la arkaa isla markaaba habka loo yaqaan angioplasty (taas oo ah, maalmo ilaa toddobaad). Si kastaba ha noqotee, marka qallal lagu galo inta lagu guda jiro "angioplasty" (taas oo ah had iyo jeer kiis maanta), khatarta hoose ee thrombosis ayaa sii socota dhowr bilood illaa dhowr sano ka dib qalliinka ka dib. Khatarta thrombosis ayaa si weyn hoos loogu dhigi karaa isticmaalka daawooyinka ka hortagga uur-qaadidda -kawase, waxay kaloo qaadaan halis.
Dhibaatooyinka kale ee dhici kara inta lagu jiro dawada cudurka anjioplasti waxaa ka mid ah waxyeello udhaca xubinta jidhka ee ay bixiso xididdada dhiigga ee la daaweeyo (oo ay ku jiraan wadna xanuunka, dhaawaca kalyaha ama qallalka), qalalka wadnaha, ama dhiig-bax.
Akhri wax dheeraad ah oo ku saabsan dhammaan doorashooyinka daweynta ee cudurka halbowlaha wadnaha .
> Ilo:
> Xubnaha Qorayaasha / Xubnaha Kooxda Task Force, Windecker S, Kolh P, iyo al. 2014 Tilmaamaha ESC / EACTS Tilmaamaha Maqal-Xajinta Miisaaniyadda: Hawl-wadareedka Dib-u-celinta Miyokardiyaanka ee Bulshada Bariga Yurub (ESC) iyo Ururka Yurub ee Qalliinka Wadnaha (Cardi-Thoracic Cervancy) (EACTS) Waxaa lagu horumariyay deeqda gaarka ah ee Ururka Midowga Yurub ee Ka Hortagga Wadnaha (Percutaneous Cardiovascular Interventions) EAPCI). Eur Heart J 2014; 35: 2541.
> Fihn SD, Blanking JC, Alexander KP, et al. 2014 ACC / AHA / AATS / PCNA / SCAI / STS Feejignaanta Soo-jeedinta Xog-u-bixinta Qalliinka iyo Maareynta Bukaannada qaba Cudurka Wadnaha Iskodhka ah ee Dareemaha: Warbixinta Kulliyoolajiyadda Mareykanka ee Wadnaha / Isu-tagga Wadnaha ee Ururka Takhasuska Hababka Tababarrada, iyo Ururka Mareykanka ee Qalliinka Wadnaha, Takhaatiirta Kalkaaliyeyaasha Wadnaha ee Ka-hortagga Wadnaha, Ururka Bulshada Dhakhaatiirta Wadnaha iyo Dhibaatooyinka, iyo Bulshada Qalliinka Thoracic. J Am Coll Cardiol 2014; 64: 1929.