I-Angiography / i-Angioplasty

I-Angiography/ I-Angioplasty e-Hyderabad, e-India

I-Coronary artery disease (CAD) ihlasela izigidi zabantu eNdiya, ikakhulukazi abantu asebekhulile, okwenza kube uhlobo oluvame kakhulu lwesifo senhliziyo. Izifo ze-coronary artery zenzeka ngenxa yesimo esaziwa ngokuthi i-atherosclerosis (imithambo ye-coronary emincane futhi eqinile).

Ukungenelela kwe-coronary percutaneous kuye kwavela njengento eyinhloko yokwelashwa okungenasidingo ezigulini ezinezifo ze-coronary artery. I-coronary angiography kanye ne-angioplasty isetshenziswa ekuxilongeni, ekuhlaziyeni, nasekwelapheni ukuvaleka kwemithambo yegazi, kodwa kunezithiyo ezithile kule ndlela yokuxilongwa. Lapho i-coronary angioplasty ihlanganiswa nale ndlela yokuqina, ibizwa ngokuthi i-percutaneous coronary intervention (PCI).

Kwenzekani ku-angiography?

I-Angiography iyindlela yokuhlola Isibhedlela esihle kakhulu se-Angiography eHyderabad ukuhlola imithambo yegazi kusetshenziswa ama-X-ray. Ngaphambi kokusebenzisa i-X-ray, igazi lidaywa ngombala okhethekile ukuze imithambo yegazi ibonakale ngokucacile ku-angiography. Kusetshenziswa i-X-ray, imithambo yegazi iyagqanyiswa, okuvumela udokotela wenhliziyo ukuthi abone ukuthi azikho yini izinkinga. Ngakho-ke, izithombe ezidalwe kusetshenziswa i-X-ray zibizwa ngokuthi ama-angiogram. 

Kungani i-angiography isetshenziswa?

I-Angiography isetshenziselwa ukuhlola ukuthi igazi eligeleza emithanjeni yakho livalekile yini ngesizathu esithile. Izibhedlela ze-CARE zihlinzeka ngokwelashwa kwe-angiography e-Hyderabad kanye nezinqubo zokuxilonga zokuxilonga noma ukuphenya izinkinga eziningi ezithinta imithambo yegazi yeziguli. Lezi zinkinga zempilo zihlanganisa:

• I-aestrosclerosis - Lesi yisimo lapho imithambo yegazi iba mincane futhi ingabeka othintekile engcupheni yokuhlaselwa yinhliziyo noma isifo sohlangothi.
• Isifo se-peripheral arterial - lesi simo sinciphisa ukunikezwa kwegazi emisipha yomlenze.
• I-aneurysm yobuchopho - lokhu kwenzeka uma kuneqhubu emithanjeni yegazi yobuchopho.
• Angina - lapho ukugeleza kwegazi emisipha yenhliziyo kuncipha, kuba nobuhlungu obubukhali esifubeni futhi kubangela i-angina pectoris noma ukuhlasela kwenhliziyo.
• Embolism yamaphaphu -ukuvinjelwa okubangelwa amahlule egazi emithanjeni yegazi ephakela amaphaphu.

Ukuvaleka kwamahlule egazi emithanjeni yegazi kunikeza igazi ezinso.

Iyini i-angioplasty?

I-Angioplasty iyindlela yezokwelapha esetshenziselwa ukwelapha ukuvinjwa okubangelwa ukunqwabelana kwamafutha ne-cholesterol emithanjeni ehlukahlukene emzimbeni. Isiza ezimweni ezithile ezifana nalezi:

• Izinkinga Zenhliziyo (I-Coronary Artery Disease): Uma unomthambo wenhliziyo omncane noma ovimbekile, i-angioplasty ingadambisa ubuhlungu besifuba futhi ivimbele ukuhlaselwa yinhliziyo ngokuqinisekisa ukuthi inhliziyo yakho ithola umoya-mpilo owanele.
• Izinkinga Ezingalweni, Emilenzeni, NasePelvis (I-Peripheral Artery Disease): I-Angioplasty isetshenziselwa ukubhekana nokuvinjelwa emithanjeni emikhulu yezingalo, imilenze, ne-pelvis ehlobene nesifo se-peripheral artery.
• Imithambo Evinjiwe Entanyeni (I-Carotid Artery Disease): I-Angioplasty isiza ekuvuleni imithambo entanyeni, ivimbele imivimbo ngokuqinisekisa ukuthi umoya-mpilo owanele ufinyelela ebuchosheni.
• Izinkinga Zezinso (Isifo Sezinso Ezingamahlalakhona): Lapho uqweqwe lwe-plaque luthinta imithambo yezinso, i-renal artery angioplasty isetshenziselwa ukuthuthukisa ukulethwa komoyampilo ezinso, kunciphisa umthelela wesifo sezinso esingamahlalakhona.

Izinzuzo ze-Angioplasty

• Ukugeleza Kwegazi Okuthuthukisiwe: I-Angioplasty isiza ukubuyisela ukugeleza kwegazi okufanele ngokunweba imithambo emincane emincane noma evinjiwe, inciphise izimpawu ezinjengobuhlungu besifuba noma ubuhlungu bomlenze obuhambisana nokungatholakali kwegazi okwanele.
• Ukuvimbela Ukuhlaselwa Kwenhliziyo Nokushaywa Kohlangothi: Esimweni se-coronary noma i-carotid artery disease, i-angioplasty ingavimbela ukuhlasela kwenhliziyo nokushaywa unhlangothi ngokubhekana nokuvinjwa nokuqinisekisa ukutholakala komoyampilo owanele enhliziyweni nasengqondweni.
• Ukukhululwa Kwezimpawu: Iziguli ezinezimo ezinjenge-peripheral artery disease zivame ukuzwa ubuhlungu noma ubunzima bokuhamba ngenxa yokuncipha kokugeleza kwegazi emilenzeni. I-Angioplasty ingadambisa lezi zimpawu, ithuthukise ikhwalithi yokuphila yonke.
• I-Invasive Kancane: I-Angioplasty iyindlela engavamile kakhulu yokuvula ukuhlinzwa. Ngokuvamile kuhilela ukusika okuncane, ukunciphisa isikhathi sokutakula kanye nezinkinga uma kuqhathaniswa nezinqubo eziningi ezihlaselayo.
• Ukwelashwa Ngokwezifiso: Inqubo ingase ihambisane nezidingo ezithile zesiguli ngasinye, iqondise ukuvinjelwa emithanjeni ehlukene emzimbeni wonke.

Izingozi ezihilelekile ku-angiography

I-Angiography ngokuvamile iyindlela ephephile futhi engenabuhlungu. Nokho, umuntu angase abe nobuhlungu, imihuzuko, noma isigaxa endaweni lapho kusikeka khona ngenxa yokuqoqwa kwegazi. Umuntu angase abonise ngisho nokungezwani nodayi. Kungase kube nezinkinga zempilo ezimweni ezingavamile kakhulu, ezihlanganisa ukushaywa unhlangothi noma isifo senhliziyo.

Izingozi zokuthembela kwe-angiographic:

I-Angiography isetshenziswe kakhulu kakhulu ekungeneleleni kwe-coronary percutaneous (PCI) kodwa inemikhawulo futhi. I-Angiography isinika isithombe esinezinhlangothi ezimbili (sisebenzisa i-X-ray) sesakhiwo esinezinhlangothi ezintathu futhi asisizi ukuchaza ukwakheka komthambo wenhliziyo. Ukwengeza, i-angiography ayinikezi ulwazi nge-plaque morphology noma ukuqina noma indawo ye-calcium. Le ndlela futhi ayikwazi ukuhlinzeka ngosayizi we-lumen onembile futhi okhiqizekayo.

I-coronary angioplasty kanye nokusetshenziswa kwayo:

Ngemva kokuxilongwa, uhlelo lokwelapha lwenziwa ezigulini ezinemithambo emincane noma evalekile. Igama elithi "angioplasty" lisho ukusetshenziswa kwebhaluni ukuvula umthambo ovalekile. Ukusebenzisa le nqubo, i-stent ibekwa endaweni yokuvinjelwa ukuze ivuleke i-artery emincane noma evinjiwe futhi ivumele igazi ukuthi ligeleze ngokukhululekile.

Izibhedlela ze-CARE, okuyiSibhedlela esingcono kakhulu se-Angiography e-Hyderabad, zenza i-coronary angioplasty zisebenzisa ubuchwepheshe besimanje. Sinikeza izinqubo zokuhlinza ezingangeneleli kancane, ezithuthukile, nesimanje ukuze siqinisekise ukuthi iziguli zithola ukunakekelwa kokwelashwa kokuphela futhi zilulame ngokushesha ngaphandle kwezinkinga zangemva kokuhlinzwa.

I-Angioplasty ngokuvamile isetshenziswa kubantu asebekhulile abane-atherosclerosis. Abantu abaye bahlushwa i-angina ebangelwa ukuvivinya umzimba noma ukucindezeleka bangelashwa ngemithi kodwa i-angioplasty iqinisekisa ukuqhubeka kokunikezwa kwegazi ngisho nasezimeni ezinzima lapho imithi ingase ingasebenzi ngesizathu esithile.

Izibhedlela ze-CARE zingasiza kanjani?

Ezibhedlela ze-CARE, i- Isibhedlela esingcono kakhulu se-angiography e-Hyderabad, abasebenzi abaqeqeshwe kahle bezinhlaka eziningi banamathela ezindinganisweni zamazwe ngamazwe kanye nezinqubo zokwenza izinqubo ezihlasela kancane ezigulini ezilandela ukuxilongwa okunembile kwezifo zenhliziyo kusetshenziswa ubuchwepheshe bethu besimanje, kanye nezinqubo zokuhlinza ezithuthukile nezesimanje. Sithemba futhi ukunciphisa ukuhlala ezibhedlela nokusheshisa ukululama ngokuhlinzeka ngosizo lwezokwelapha ngaphandle kwesibhedlela. Sisebenzisa i-optical coherence tomography (OCT) kanye ne-angiography ukuze sibhale isakhiwo sangaphakathi semithambo yegazi ukuze sibukwe ngokucacile futhi sihlonze noma yikuphi ukungahambi kahle kwesakhiwo okubangelwa ukuvinjelwa okufana noqwembe.

Kungani usebenzise i-OCT?

Intuthuko yakamuva ku-interventional cardiology igcizelele ukubaluleka kokwenza ukuhlaziya okuningiliziwe kwezimpawu zezicubu zezilonda ze-coronary atherosclerotic, okuhlanganisa ukuhlonza ukuzinza kwama-plaque kanye nokulinganisa kokumbozwa kwezilonda. I-Optical Coherence Tomography (OCT) iyindlela yokuxilonga esetshenziswa ngesikhathi sokwenziwa kwe-catheterization yenhliziyo. Ngokungafani ne-ultrasound, esebenzisa amaza omsindo ukuze kwakhe isithombe sezingxenye zezicubu nemithambo yegazi, i-OCT isebenzisa ukukhanya ukuze ithole izithombe zemithambo yegazi. Ngokuhlinzeka ngezithombe ezinokulungiswa okuphezulu kwengaphakathi lomthambo, i-OCT ishintsha imvelo yendlela iziguli eziphathwa ngayo. I-OCT ingasetshenziswa ngaphambi nangemuva kwe-PCI ukuqondisa ukuhlelwa kwenqubo nezinqumo zokwelashwa.

Izicelo ezintathu eziyinhloko ze-OCT yilezi:

• Ukuhlolwa kwe-atherosclerotic plaque

• Ukuhlolwa kokuma kanye nokufakwa kwe-stent

• PCI umhlahlandlela kanye nokwenza kahle.

Isebenza kanjani i-OCT?

I-OCT isebenzisa ukukhanya okucishe kube yi-infra-red wavelength ukuze idale izithombe zemithambo yenhliziyo. Le nqubo iletha izithombe ezinokulungiswa okuphezulu kakhulu. I-beam yokukhanya iboniswa emthanjeni, futhi okunye ukukhanya kubonakalisa ngaphakathi kwezicubu ze-artery ngenkathi ukukhanya okunye kuhlakazeka, okuhlungwa ku-OCT. I-OCT ivumela odokotela benhliziyo ukuthi babone ingaphakathi lomthambo wegazi cishe izikhathi ezingu-10 ngaphezu kwalokho ababengaba nakho ngenkathi besebenzisa i-intravascular ultrasound. 

I-OCT isetshenziswa kanye nezinqubo ze-catheterization yenhliziyo, okuhlanganisa i-angioplasty, lapho odokotela benhliziyo besebenzisa khona ibhaluni elincane elingaphezulu ukuze bavule amabhlogo kumthambo wenhliziyo. Iziguli eziningi ezenza ibhaluni i-angioplasty, zithola idivayisi efana ne-mesh, ebizwa ngokuthi i-stent, ukugcina umthambo uvulekile. I-OCT imaging ingasiza odokotela ukuthi bahlole ukuthi i-stent isebenza kahle yini noma ukuthi i-stent ibekwe ngendlela efanele yini ngaphakathi komthambo. Akugcini lapho, kodwa izithombe ze-OCT ziphinde zivumele odokotela babone ukuthi likhona yini i-plaque.

Izinzuzo nge-Angiography Ucwaningo oluningi lukhombisa ukuthi imaging ye-intravascular ultrasound ihlala ingcono kunokudaya kanye ne-X-ray imaging ukuze kusebenze kangcono emtholampilo. I-OCT iyinqubo yokuxilonga ehlaselayo futhi idinga isikhathi esincane ukuze unikeze izithombe ezinembe kakhulu. I-fluorescein angiography ihilela ukusetshenziswa kodayi abajovwayo okuthatha isikhathi ukufika emikhunjini ecwaningwayo futhi kungase kubangele ukungezwani komzimba ne-anaphylactic esigulini. Ngaphezu kokuhlaziywa kwekhwalithi okwenziwa ku-angiography evamile, indlela esekelwe ku-OCT inikeza ukuhlaziywa komthamo wemithambo yegazi. Njengoba sekushiwo, i-OCT ihlinzeka ngesithombe sezinhlangothi ezintathu ze-macula futhi ibone ngeso lengqondo ama-capillaries, ngokungafani kakhulu ne-angiography ebonisa izakhiwo ezinezinhlangothi ezimbili zezakhiwo ezinezinhlangothi ezintathu. Mayelana nokunemba kwe-OCT, ucwaningo lubike izinga lokucaciswa elingamaphesenti angama-90 uma kuqhathaniswa nesilinganiso samaphesenti angama-67 esiwusizo kithi ngokusebenzisa i-angiography. Enye inzuzo ye-OCT ikhono layo lokubona ngeso lengqondo i-vasculature, ithuthukisa amandla okubona ngeso lengqondo izilonda ze-neovascular kanye nokukhula kwe-polypoidal. 

I-OCT ihlinzeka ngethuluzi elihlaselayo nelifaneleka lokubhala nokuhlonza izifo zemithambo, ngokuboniswa okunembe kakhulu kwezingxenye ezihlukene kanye nezinhlangothi ezintathu. Naphezu kwalezi zinzuzo, muningi umsebenzi okufanele wenziwe ngaphambi kokuba ubuchwepheshe busetshenziswe njalo ezigulini kanye ne-angiography esikhundleni sokusebenzisa indlela ye-angiographic iyodwa.