I-Angioplasty-ebizwa nangokuthi "i-angioplasty ye-coronary coronary angioplasty," okanye i-PTCA-yinkqubo yokwenza i- catheterization ejolise ekunciphiseni iimpawu zokungena kwiingxubevange, eziqhelekileyo kwimibhobho ye-coronary .
I-Angioplasty isebenza ngokuphelisa ibhaluni elincinci ngaphakathi kwipetroti kwisiza se- atherosclerotic plaque , ukucwenga i-plaque kunye nokunciphisa i-stenosis (ukucinywa) ngaphakathi komthamo.
Phantse kwimeko nganye i-angioplasty ihamba kunye nokufakwa kwe-stent .
I-Angioplasty Yenzani
Ukwenza i-angioplasty, ugqirha usebenzisa i-catheter (ityhude ende, inqabileyo, eguquguqukayo) enebholethi edibeneyo. I-catheter idluliselwa kuyo yonke i-plaque eyenza ukukhutshwa, kwaye ibhaluni iyancipha phantsi kwengcinezelo. Ukwandiswa kwebhaluni kugxininisa i-plaque ngokubhekiselele eludongeni lwe-artery. Xa ibhaluni ihlanjululwe kwaye isusiwe, i-plaque ihlala ingcinezelo encinci, ngoko ukucinywa kunciphise.
Ngoxa i-angioplasty yayisenziwa ngokusemthethweni njengendlela yokuzimelela yodwa, namhlanje i-stent nayo ifakwe nayiphi na i-angioplasty kwi-artery coronary. I-stent yi-"scaffold" eyandiswayo ekunceda ukuxhasa udonga lomthambo kwisayithi ye-angioplasty, ukuze kugcinwe i-plaque. I stent ehlile ifakwe phezu kwebhaluni ngaphambi kokuba ifakwe.
Emva koko, xa ibhaluni ibonisiwe, i-plaque icinezelwe kwaye i-stent iyandiswa ngexesha elinye. Xa ibhaluni iyahlanjululwa kwaye isuswe, i-stent ishiywe endaweni, inceda ukugcina i-plaque igxininiswe kwaye i-artery ivuliwe.
Xa Kunceda
I-Angioplasty iyasebenza kakhulu ekunciphiseni iimpawu ze- angina esomeleleyo .
Ngoko isizathu esiyinhloko sokwenza i-angioplasty kwintsimbi ye-coronary ukuphatha i-angina ehlala iqhubekayo naphezu kwemizamo yonyango lweyeza. Nangona kunokuba kubonakale kumangalisa kuninzi, i-angioplasty (nangona xa i-stent efakwe) ayizange iboniswe ukuba isebenze ngakumbi kunonyango lonyango ekunciphiseni umngcipheko we- myocardial infarction (intliziyo yesifo), okanye ukuphucula ubomi. Ngoko isizathu esona sikhulu sokwenza i-angioplasty kukukhupha i-angina eqinile eqhubekayo nangona kunjalo ukuzama ukunyanga.
Isizathu sesibini sokuba i-angioplasty (kunye ne-stenting) isoloko isetyenziselwa ukunyanga isifo se-artery coronary syndrome (ACS). Kwi-ACS, ukukhutshwa ngokukhawuleza komthambo we-coronary kwenzeka ngenxa yokuba i-plaque iye yaphuka kwaye i-clot yenziwe ngaphakathi komda. Xa i-ACS ivela, kukho ukuhlaselwa kwentliziyo ngaphandle kokuba i-artery ivuliwe. Ngexesha le-ACS, ubungqina obukhoyo bubonisa ukuba i-angioplasty kunye ne-stenting inokukunceda kakhulu ekuphuculeni iziphumo zomzimba jikelele.
Iingxube ze-coronary are not only the arteries apho i-angioplasty isetyenziselwa ukukhusela i-atherosclerotic plaques. I-Angioplasty iphinda isetyenziswe kwiimitha ze-carotid (ezinika ubuchopho), iirriyiti ze-renal (ezinikezela iintso) kunye nemilenze yomlenze.
Iingxaki
Inkxalabo eqhelekileyo elandela i-angioplasty yodwa i- restenosis - ukubunjwa kokutsha okutsha kwisiza se-plaque egxininiswe. I-Restenosis yinkqubo ephosakeleyo ebangelwa ukukhula okutsha kweethambo-mhlawumbi ekuphenduleni i-traum evezwe ngaphakathi kunye nodonga lwezithuthi nge-angioplasty ngokwayo. Isiganeko sokuphumula siphelile kakhulu ngokusetyenziswa kweentsimbi, ikakhulukazi izidakamizwa-e-stuting (DES), ezifakwe ngamachiza avimbela ukukhula kwezicubu, ngokunjalo ukunciphisa ukuphumla.
Ngaphambi kwexesha leentsholongwane, i-restenosis yexesha elide yenzeke malunga ne-30% yezigulane ezazingenayo i-angioplasty yodwa.
Ukusetyenziswa kweentsimbi ezingenanto kunganciphisa umngcipheko ongaphantsi kwama-15%, kwaye i-stuting-eluting stents yanciphise ngaphezulu kwe-10%.
Ingxaki engezantsi, kodwa enye eyonakalisayo, i-thrombosis (i-clotting blood) kwisayithi ye-angioplasty / stenting. I-thrombosis ene-stent yinto eyenzeka ngokukhawuleza kwaye yenzeke yintlekele, eyenza ngokuvelisa umqobo opheleleyo kunye nokugqiba ngokupheleleyo umzobo ochaphazelekayo. I-thrombosis ibonakala ngokukhawuleza emva kwenkqubo ye-angioplasty (oko kukuthi, ngaphakathi kweentsuku ukuya kwiiveki). Nangona kunjalo, xa i-stent ifakiwe ngexesha le-angioplasty (elisoloko lihlala kunjalo namhlanje), umngcipheko ophantsi we-thrombosis uqhubeka kwiinyanga eziliqela ukuya kwiminyaka emininzi emva kwenkqubo. Umngcipheko we-thrombosis uyancitshiswe kakhulu ngokusetyenziswa kwezidakamizwa ezichasene ne- plaletlet-noko, nangona kunjalo, nazo zibeka ingozi.
Ezinye iingxaki ezinokuthi zenzeke ngethuba le-angioplasty ziquka umonakalo kwilungu elibonelelwa ngumkhumbi wegazi (kubandakanya ukuhlaselwa kwentliziyo, ukulimala kweentso okanye ukubetha), i-arrhythmias ye-cardiac, okanye i-bleeding.
Funda ngokubanzi malunga nonyango olukhethiweyo lwe-coronary artery disease .
> Imithombo:
> Abalobi / amalungu eQela leMisebenzi, i-Windecker S, uKolh P, et al. 2014 ESC / EACTS Izikhokelo kwi-Myocardial Revascularization: I-Task Force kwi-Myocardial Revascularization ye-European Society of Cardiology (ESC) kunye ne-European Association yeCrodio-Thoracic Surgery (EACTS) Iphuhliswe ngegalelo elikhethekileyo loMbutho we-European Association of Percutaneous Cardiovascular Interventions ( EAPCI). I-Eur Heart J 2014; 35: 2541.
> Fihn SD, Blankenship JC, uAlexander KP, et al. 2014 ACC / AHA / AATS / PCA / SCAI / STS Ukuhlaziywa okugxilwe kuyo kwiSikhokelo soLwazi kunye nokuPhathwa kweziGulane ezineSifo seSikhemikhali senhliziyo: iNgxelo ye-American College of Cardiology / i-American Heart Association iqela leMikhombandlela yokuSebenza, kunye Umbutho waseMerika woTyhutyrikhi, i-Preventive Cardiovascular Association, uMbutho weeNdiovvascular Angeography kunye neNguqulelo, kunye noMbutho weeTrhage zoTyholo. J Am Coll Cardiol 2014; 64: 1929.