Iyo carotids itsinga inopa uropi, mutsipa uye chiso. Carotid stenosis ndiyo huru pathology inofanirwa kutyiwa. Zvichienderana nezera, zvinogona kana kusatungamira kune sitiroko yenguva pfupi.

Uropi hunopihwa netsinga dzakasiyana: maviri carotid arteries pamberi uye maviri vertebral arteries kumashure. Tsinga ina idzi dzinosangana mujinga medehenya kuti dziumbe inonzi Polygon of Willis.

Iyo inonzi inonzi primary kana common carotid artery inomuka kubva muaorta uye inokwira mumutsipa. Inoparadzanisa pamwero wepakati pemutsipa mutsinga mbiri: mukati carotid uye yekunze carotid. Iyi junction zone inonzi carotid bifurcation.

Iyo yemukati carotid arteries inopa kuuropi, nepo ekunze carotid arteries inopa kumutsipa nekumeso. Izvi naizvozvo zvakakosha zvikuru tsinga.

Carotid stenosis ndicho chironda chikuru chekutya mutsinga ye carotid.

Inoenderana nekuderera kwehupamhi hweiyo carotid artery, kazhinji inotevera kuumbwa kweatheromatous plaque (deposition ye cholesterol, fibrous uye calcareous tishu) mukati me arteri. Muzviitiko zvakawanda (90%), iyi stenosis inowanikwa pamwero wekervical carotid bifurcation.

Ngozi ndeyokuti tsinga ye carotid inoguma yavharwa neatheromatous plaque kana kuti ichatsemuka. A transient ischemic attack (TIA) inogona kuitika iyo inodzokorora pasina sequelae mumaawa asingasviki 24, kana njodzi yecerebrovascular (AVC) kana cerebral infarction, ine zvimwe kana zvishoma zvakakomba sequelae.

Carotid stenosis yakajairika nezera: maererano neHaute Autorité de Santé, 5 kusvika 10% yevanhu vanopfuura 65 vane stenosis inopfuura 50%. Carotid stenosis inofungidzirwa kuve inokonzera chikamu chechina chesitiroko.

Kutungamirirwa kwecarotid stenosis kunobva pakurapwa kwezvinodhaka, kutonga kwevascular risk factor uye kune vamwe varwere nzira yekudzorerazve.

Panyaya yekurapa zvinodhaka, marudzi matatu emishonga anorongedzerwa pamwe chete: antiplatelet agent kutetepa ropa, statin inodzikamisa kukura kweatheromatous plaques uye ACE inhibitor (kana beta blocker mune dzimwe nguva).

Nezve revascularization, French National Authority yeHutano yakapa kurudziro yechiratidzo chekuvhiyiwa zvinoenderana nechiyero chechiratidzo carotid stenosis:

• pakati pe70 ne99% ye stenosis, kuvhiyiwa kunoratidzwa neakaenzana akakosha kubatsirwa muvarume nevakadzi;
• pakati pe50 ne69% stenosis, kuvhiyiwa kunogona kuratidzwa asi kubatsirwa kuduku, kunyanya kuvakadzi;
• pakati pe30 ne49%, kuvhiyiwa hakubatsiri;
• pasi pe30%, kuvhiyiwa kwacho kwakaipa uye hakufanirwe kuitwa.

Kana revascularization inoratidzwa, kuvhiyiwa kunoramba kuri chiyero chegoridhe. Nzira yacho, inonzi carotid endarterectomy, inowanzoitwa pasi peanesthesia. Chiremba anovhiya muhuro, anosunga tsinga nhatu obva acheka tsinga yecarotid pamwero we stenosis. Anobva anyatsobvisa dombo re<em>atherosclerotic plaque nemarara aro, obva avhara tsinga yacho newaya yakanaka kwazvo.

Angioplasty ine stent haina kuratidzwa semutsetse wekutanga kurapwa. Inongopihwa mune zvimwe zviitiko zve contraindication pakuvhiya.

Kana paine asymptomatic carotid stenosis:

• mukuru kupfuura 60%: revascularization nekuvhiyiwa kwecarotid inogona kuratidzirwa zvichienderana nezvimwe zvinhu (hupenyu hunotarisirwa, kufambira mberi kwe stenosis, nezvimwewo);
• kana stenosis isingasviki 60%, kuvhiyiwa hakuratidzwi.

Pamwe chete nemishonga uye kurapwa kwekuvhiya, zvakakosha kuti uongorore mararamiro ako kuti udzikise njodzi: high blood pressure, fodya, hypercholesterolemia uye chirwere cheshuga.

Carotid stenosis inogona kunge isina zviratidzo uye inowanikwa panguva yekuongororwa kwechiremba nachiremba wako kana nyanzvi, kana panguva yekuongororwa kwe thyroid semuenzaniso. Kuvapo kwekugunun'una kwecarotid pa auscultation kunofanira kutungamirira kune kunyorerwa kwe carotid doppler ultrasound kuti iongorore inogona kuitika carotid stenosis uye kuongorora chiyero chekudzivisa. Zvichienderana nemigumisiro, MRI angiography, CT angiography kana digital carotid angiography ichanyorwa. Zvinoita kuti zvikwanise kuona nzvimbo, morphology uye kuwedzera kweplaque, uye kuongorora kupararira kweatheroma kune mamwe maaxes uye kunyanya imwe carotid artery.

Kana paine zviratidzo, zviratidzo zvecarotid stenosis ndezvenguva pfupi ischemic kurwisa (TIA) uye sitiroko. Pamwe, zvichienderana nenzvimbo yehuropi yakakanganiswa:

• kukuvara kweziso (kamwe kamwe uye kusingarwadzi kurasikirwa kwechiratidzo mune rimwe ziso kana chinguva chidiki amaurosis);
• kuremara kune rimwe divi remuviri, kungave kwakazara kana kugumira kunhengo yepamusoro uye / kana kumeso (hemiparesis, kuoma kwechiso);
• kurasikirwa kwekutaura (aphasia).

Kutarisana nezviratidzo izvi, zvakakosha kubata 15.