I-Restenosis ibhekisela ekunciphiseni ngokukhawuleza kwe- coronary artery emva kokucinywa kwanyangwa nge- angioplasty kunye ne- stenting . Ukuba i-restenosis iyenzeka, ngokuqhelekileyo iyenzeka kwiinyanga ezi-3 ukuya kwezi-12 zenkqubo. Ngenxa yokuba i-restenosis yenza i-artery ibe yincinci kwakhona, iimpawu ze- angina zivame ukubuyela.
I-Restenosis yaqatshelwa njengengxaki kwiintsuku zokuqala ze-angioplasty, ezenzeka kuma-40 ukuya kuma-50% abantu abaphathwa nge-angioplasty bodwa.
Enyanisweni, i-stents reason for the first place was to reduce the incidence of restenosis.
Kwinqanaba elithile, i-stents iphumelele ngokwenza njalo. Ngaphandle kwesizukulwana sokuqala se-metal stents (BMS), iziganeko zokuphumula zancitshiswa kakhulu (ukuya kuma-20 ukuya ku-30% kwiinyanga ezili-12). Emva koko, izilwanyana ezixilisayo izidakamizwa (DES) zaphuhliswa ukuze zizame ukunciphisa ukuphumla kwakhona. Kwi-DES, i-stents ifakwe iziyobisi ezivimbela ukukhula kweethambo ezikhokelela ekuphumuleni.
Isizukulwana sokuqala se-DES sincitshiswe iziganeko zokuphumula kwi-15% kwiminyaka emihlanu. I-DES entsha yanciphise izinga lokuphumla ngakumbi, ukuya kuma-5 ukuya ku-7% kwiminyaka emihlanu.
Yintoni Ebangelwa I-Restenosis?
I-Angioplasty (kunye nokufakwa kwesigxina, njengoko ihlala ihamba kunye ne-angioplasty) yindlela yokuxhatshazwa kwezicubu. Ngethuba le-angioplasty, i-cathterta ethwele ibhaluni ehlanjululwayo idluliselwa kwi- plaque ye-atherosclerotic kwi-coronary artery, kwaye ibhaluni iyancipha.
Ukunyuka kwamaxabiso kwibhaluni kugxininisa i-plaque, ngaloo ndlela kwandisa ukuvulwa komthambo. I-stent-inkqubo ye-struts encinci - yandiswa kwi-angioplasty, ukugcina i-artery eyandisiweyo ingawa phantsi. Ukunyanzeliswa (okanye "ukutshitshisa," ukuba ukhetha) kwiplani akuyona inkqubo emnene, kwaye ihlala idala ingozi kumdonga wegazi.
I-Restenosis iyenzeka ngenxa yokukhula kwamathambo kwisiza sonyango. Ingacinga ukuba icingelwe ngokuba ngumphumo wenkqubo "yokuphulukisa" emva koxinzelelo lwengqondo lwe-angioplasty. Iiseli eziphelayo eziqhelekileyo zibeka umgca we-coronary umthamo okhulayo kwisiza soxinzelelo. Ukuba ukwanda kweeseli eziphelayo kukugqithiseleyo, iiseli ziyakunqanda isitya segazi kwisiza se-stent.
I-Restenosis nayo ingenzeka ngenxa ye-atherosclerosis ephindaphindiweyo-inkqubo eyabangela ukuba i-coronary artery igcinwe kwindawo yokuqala. I-restenosis ebangelwa yi-atherosclerosis ihlala ibonakala ixesha elide emva kwenkqubo - unyaka okanye ngaphezulu. Ukugqithisa okuqhelekileyo, okuqhelekileyo kubonwe kwiinyanga ezili-6 kwaye phantse rhoqo kwiinyanga ezili-12 zilandela inkqubo, ngokuqhelekileyo kubangelwa ukukhula kweethambo.
Restenosis vs. Thrombosis
I-Restenosis ayifani nentsholongwane eyoyikisayo-ukutshatyalaliswa ngokukhawuleza kwe-stent ukusuka ekubunjweni kwegazi. I-thrombosis ene-stent iqhelekileyo yintlekele, kuba ivelisa ngokukhawuleza kunye nokupheliswa okupheleleyo kwintsimbi ye-coronary. Umngcipheko we-thrombosis uphezulu kwiiveki ezimbalwa okanye iinyanga ezimbalwa emva kokufakwa kwesigxina, kodwa kuncitshiswe kakhulu ngokusetyenziswa kwezilwanyana ezikhubaza iiplatelet .
Kukho umngcipheko omncinci kodwa wangempela we-thrombosis evelele ekupheleni kwexesha okanye ngaphezulu emva kokuba i-stent ibekwa-kwaye kwiminyaka yamuva ibonakala ukuba izidakamizwa ezichasene nazo kufuneka ziqhutywe phambili okungenani omnye unyaka kwaye mhlawumbi zide . Indlela efanelekileyo yokukhusela i-stent thrombosis, emva koko, iphikisana.
I-Restenosis ithathwa njani?
Nangona ukusetshenziswa kwe-DES kuye kwanciphisa kakhulu iziganeko zentlungu yokuphumla, ayizange isuse ingxaki.
Ukuba i-restenosis yenzeka kwaye ivelisa iimpawu ze-angina, unyango ngokuqhelekileyo lubandakanya inkqubo yokuphindaphinda-ngokuqhelekileyo, ukufakwa kwesibini esendaweni enye.
Unyango lwezonyango (noninvasive) lwe-angina lusekho . Utyando lweCoronary bypass surgery yindlela enye kubantu abane-stent restenosis, ingakumbi ukuba ukuba i-restenosis ibuyela emva kwesibini.
Isishwankathelo
I-Restenosis ekuqaleni yayiyimiqobo emikhulu ekusebenziseni i-angioplasty kunye neentente ze-coronary disease. Njengoko iteknoloji ye-stent iye yaphucula, i-restenosis sele ithatyathwa kakhulu njengengxaki. Nangona kunjalo, ukusetyenziswa kwamagqabi anamhlanje kuye kwazisa enye ingxaki yokulawula ekunakekeleni kwe-coronary artery disease-stent thrombosis. Indlela efanelekileyo yokunciphisa umngcipheko wale ngxaki entsha isasebenza.
> Imithombo:
> Dangas GD, Claessen BE, Caixeta A, et al. I-Restenosis yase-Stent e-Stuting-eluting Stent Era. J Am Coll Cardiol 2010; 56: 1897.
> I-Piccolo R, uStefanini GG, uFranzone A, et al. Ukhuseleko kunye neNtsebenzo ye-Resolute Zotarolimus-e-Stuting Stents kuthelekiswa ne-Everolimus-eluting Stents: uhlalutyo lwe-Meta. I-Circ Cardiovasc Interv 2015; 8.
> Räber L, Wohlwend L, Wigger M, et al. Iminyaka emihlanu yeeKlinikhi kunye neziphumo zeNgxelo zeNgxelo ze-Angloographic of Comparison Randomised of Sirolimus-eluting and Paclitaxel-eluting Stents: Iingcamango zeSirolimus-Eluting Versus Paclitaxel-Eluting Stents yeCononary Revascularization. Ukuhamba ngo-2011; 123: 2819.