Carotids sune arteries da ke ba da kwakwalwa, wuyansa da fuska. Carotid stenosis shine babban cututtukan da za a ji tsoro. Kwatankwacin na kowa tare da shekaru, yana iya ko bazai haifar da bugun jini na wucin gadi ba.

Ana ba da kwakwalwa ta hanyoyi daban-daban: arteries carotid biyu a gaba da kuma jijiyoyin kashin baya biyu. Wadannan arteries guda hudu sun hadu a gindin kwanyar don samar da abin da ake kira Polygon of Willis.

Abin da ake kira na farko ko na kowa na carotid artery yana fitowa daga aorta kuma ya hau cikin wuyansa. Yana raba a matakin tsakiyar wuyansa zuwa arteries biyu: na ciki carotid da waje carotid. Ana kiran wannan yankin junction carotid bifurcation.

Jijiyoyin carotid na ciki suna ba wa kwakwalwa, yayin da jijiyoyin carotid na waje ke ba da wuya da fuska. Don haka waɗannan su ne masu mahimmancin arteries.

Carotid stenosis shine babban rauni ga tsoro a cikin jijiyoyin carotid.

Ya dace da raguwa a cikin diamita na artery carotid, mafi yawan lokuta biyo bayan samuwar plaque atheromatous (zubar da cholesterol, fibrous da calcareous kyallen takarda) a cikin jijiya. A mafi yawan lokuta (90%), wannan stenosis yana cikin gida a matakin ƙwayar carotid bifurcation na mahaifa.

Haɗarin shine cewa jijiyoyin carotid za su ƙare da toshe shi da plaque na atheromatous ko kuma zai gutsuttsura. Harin ischemic na wucin gadi (TIA) na iya faruwa wanda ya sake komawa ba tare da bin diddigin a cikin ƙasa da sa'o'i 24 ba, ko haɗarin cerebrovascular (AVC) ko raunin kwakwalwa, tare da ƙari ko žasa mai tsanani.

Carotid stenosis yana da yawa tare da shekaru: bisa ga Haute Autorité de Santé, 5 zuwa 10% na mutanen da suka wuce 65 suna da stenosis fiye da 50%. An kiyasta jijiyar carotid da alhakin kusan kashi ɗaya cikin huɗu na bugun jini.

Gudanar da ƙwayar cuta na carotid ya dogara ne akan maganin miyagun ƙwayoyi, kula da abubuwan haɗari na jijiyoyi da kuma wasu marasa lafiya tsarin farfadowa.

Game da maganin miyagun ƙwayoyi, ana ba da nau'ikan kwayoyi guda uku tare: wakili na antiplatelet don siriri jini, statin don iyakance haɓakar plaques na atheromatous da mai hana ACE (ko beta blocker a wasu lokuta).

Game da revascularization, Hukumar Kula da Lafiya ta Faransa ta ba da takamaiman shawarwari don nunin tiyata bisa ga matakin alamar cututtukan carotid stenosis:

• tsakanin 70 da 99% na stenosis, ana nuna tiyata tare da fa'ida mai mahimmanci a cikin maza da mata;
• tsakanin 50 da 69% stenosis, ana iya nuna tiyata amma amfanin ya ragu, musamman ga mata;
• tsakanin 30 da 49%, tiyata ba shi da amfani;
• kasa da 30%, tiyatar ba ta da kyau kuma bai kamata a yi ba.

Lokacin da aka nuna revascularization, tiyata ya kasance ma'aunin gwal. Hanyar, wanda ake kira carotid endarterectomy, yawanci ana yin shi ne ta hanyar maganin sa barci. Likitan fiɗa ya yi yanka a wuyansa, ya danne arteries guda uku sannan ya yanke carotid artery a matakin stenosis. Sa'an nan kuma a hankali ya cire plaque atherosclerotic da tarkace, sa'an nan kuma ya rufe artery da waya mai kyau sosai.

Angioplasty tare da stent ba a nuna shi azaman magani na farko ba. Ana ba da shi ne kawai a wasu takamaiman lokuta na ƙin yarda da tiyata.

Idan akwai asymptomatic carotid stenosis:

• fiye da 60%: revascularization ta carotid tiyata za a iya nuna dangane da wasu dalilai (tsawon rayuwa, ci gaban stenosis, da dai sauransu);
• idan akwai stenosis kasa da 60%, ba a nuna tiyata ba.

Tare da magani da magani na tiyata, yana da mahimmanci a sake nazarin salon rayuwar ku don iyakance abubuwan haɗari: hawan jini, taba, hypercholesterolemia da ciwon sukari.

Carotid stenosis na iya zama asymptomatic kuma ana iya gano shi yayin binciken likita ta babban likitan ku ko ƙwararrun ku, ko lokacin duban dan tayi na thyroid misali. Kasancewar gunaguni na carotid akan auscultation ya kamata ya haifar da takardar sayan magani na carotid doppler duban dan tayi don tantance yiwuwar cututtukan carotid da kuma tantance ƙimar toshewa. Dangane da sakamakon, MRI angiography, CT angiography ko dijital carotid angiography za a rubuta. Yana ba da damar sanin wuri, ilimin halittar jiki da tsawo na plaque, da kuma tantance yaduwar atheroma a kan sauran gatari da kuma musamman sauran carotid artery.

Lokacin da alamun bayyanar cututtuka, alamun carotid stenosis sune na harin ischemic na wucin gadi (TIA) da bugun jini. Ko dai, ya danganta da yankin kwakwalwar da abin ya shafa:

• lalacewar ido (ba zato ba tsammani da raɗaɗi na hangen nesa a cikin ido ɗaya ko amaurosis na wucin gadi);
• gurguntsuwa a gefe ɗaya na jiki, ko dai duka ko iyakance ga babba da / ko fuska (hemiparesis, ɓacin fuska);
• asarar magana (aphasia).

Idan aka fuskanci waɗannan alamun, yana da mahimmanci don tuntuɓar 15.