caroted dhamani stenosis

caroted dhamani stenosis caroted dhamniyon key kissy bhee hisse kaa ack sankeern yaa sankuchan haye, joe aamtaur parr atherosclerosis key kaaran hotaa haye.
sanket aur lakshan.
aam caroted dhamani badee dhamani haye jisaki naadi jabade key neeche gardan key donon taraf mahsoos kii jaa sakati haye. dahini or yeh brachiocephalic dhamani (mahadhamani kii ack shakha) seey shuru hoti haye, aur baain or dhamani seedhe mahadhamani kamaan seey nikalati haye. galey mein yeh aantarik caroted dhamani aur baahari caroted dhamani mein pravesh kartaa haye. aantarik caroted dhamani mastishk kii aapoorti karati haye, aur baahari caroted dhamani chehare kii aapoorti karati haye. yeh kaanta atherosclerosis key liye ack samanya sthal haye, samanya caroted dhamani key ander atheromatous plaak kaa ack soojan nirmaan, yaa aantarik caroted dhamaniyan joe unhein sankeern karati hain.
pattika sthir aur lakshanheen hoe sakati haye, yaa yeh embolisation kaa srot hoe sakati haye. amboli pattika seey toot jaati haye aur mastishk mein rakt vaahikaon taka parisancharan key madhyam seey yatra karati haye. jaise-jaise vaahikaaen chhoti hoti jaati hain, ack ambolus vahika kii deewaar mein reh sakata haye aur mastishk key kuchh hisson mein rakt pravaah koo pratibandhit curr sakata haye. yeh ischemia yaa tou asthaayi hoe sakata haye, jisase kshanik ischemic hamla (tii. aaee. aeye.) hoe sakata haye, yaa sthaayi roop seey thromboembolic stroke hoe sakata haye.
kshanik ischemic hamale ack chetavani sanket hain aur isake baad gambhir sthaayi aghaat hoe sakate hain, vishesh roop seey pahale dou dinon key bheetar. paribhasha key anusaar tias 24 ghante seey bhee cumm samay taka rahata haye aur aksar shareer key ack taraf ack anga yaa dhad kii samvedana key nuksan yaa ack aankh mein drishti key nuksan (amorosis fagaks) kaa roop letaa haye. dhamani kii aavaaz (phal), yaa kaana mein bajana (tinitus) cumm samanya lakshan hain.
caroted stenosis vaale lakshanheen vyaktiyon mein, binaa stenosis vaale logon seey adhik stroke honey kaa khatra badh jaataa haye. aghaat kaa jokhim sambhavatah imaging parr stenosis kii degree seey sambandhit haye. kuchh adhyayanon mein stenosis kii badhati degree key saath jokhim mein vriddhi paaee gaee haye jabaki anya adhyayanon mein aisaa sambandh naheen paaya gayaa haye.
pathophysiology.
atherosclerosis caroted dhamani kii divaaron key bheetar pattika kaa nirmaan kartaa haye, aamtaur parr kaante parr jahaan samanya caroted dhamani aantarik aur baahari caroted dhamani mein vibhajit hoe jaati haye. pattika kaa nirmaan dhamani lumen koo sankeern yaa sankuchit curr sakata haye, ack sthiti jise stenosis kahaa jaataa haye. pattika kaa tootana atherosclerotic malba yaa rakt key thakkon koo dhamani mein chhod sakata haye. iss samagri kaa ack tukada toot sakata haye aur aantarik caroted dhamani key madhyam seey mastishk mein yatra (ambolize) curr sakata haye, jahaan yeh parisancharan koo avaruddh curr sakata haye, aur mastishk key ootak kii mrityu kaa kaaran bunn sakata haye, ack sthiti jise ischemic stroke key roop mein jaanaa jaataa haye.
kabhi-kabhi stenosis pahale asthaayi lakshnon kaa kaaran banata haye, jise tias key roop mein jaanaa jaataa haye, jahaan mastishk mein asthaayi ischemia hotaa haye, yaa binaa kissy inforction key retina hotaa haye. lakshanaatmak stenosis mein agale 2 dinon key bheetar stroke kaa uchch jokhim hotaa haye. rashtriya swaasthya aur naidaanik utkrishtata sansthaan (achchha) dishaanirdeshon mein sifarish kii gaee haye kii madhyam seey gambhir (50-99% avrodh) stenosis aur lakshnon vaale logon koo 2 saptah key bheetar "tatkaal" endarterectomy karani chaahiye.
jaba pattika lakshan paida naheen karati haye, tou logon koo abhee bhee samanya aabaadi kii tulanaa mein stroke kaa adhik khatra hotaa haye, lekin lakshanaatmak stenosis vaale logon key roop mein adhik naheen hotaa haye. ghaatak aghaat sahit aghaat kii ghatana prati varsh 1-2% haye. endarterectomy kii shalya chikitsa mrityu darr 1-2% seey laker 10 pratishat taka hoti haye. dou badey yaadrichhik naidaanik parikshanon ney pradarshit kiya haye kii 30-divasiya stroke aur 3 pratishat yaa usase cumm mrityu key jokhim key saath kii gaee caroted sergery seey 60 pratishat seey cumm stenosis vaale lakshanheen logon koo laabh hoga, jinake sergery key baad cumm seey cumm 5 saal jeene kii ummeed haye. shalya chikitsak iss baat parr vibhajit hain kii kyaa lakshanheen logon kaa ilaaj akele dawa seey kiya jaanaa chaahiye yaa shalya chikitsa kii jaani chaahiye.
aam caroted dhamani laal rung kii badee urdhvaadhar dhamani haye. caroted dhamani koo rakt kii aapoorti mahadhamani (neeche) key mehrab seey shuru hoti haye. caroted dhamani aantarik caroted dhamani aur baahari caroted dhamani mein vibhajit hoti haye. aantarik caroted dhamani mastishk kii aapoorti karati haye. pattika aksar usa vibhajan parr banati haye aur ack sankeern (stenosis) kaa kaaran banati haye. plaak key tukade toot sakate hain aur mastishk mein oopar kii chhoti dhamniyon koo avaruddh curr sakate hain, joe ack stroke kaa kaaran banata haye. mahadhamani mein caroted dhamani key mool mein bhee pattika kaa nirmaan hoe sakata haye.
nidan.
caroted dhamani stenosis kaa nidan aamtaur parr gardan mein caroted dhamniyon key rung pravaah duplexes ultrasound scan dwara kiya jaataa haye. isamen koee vikiran, koee suee aur koee vipareet agent shamil naheen hain joe allergy pratikriyaon kaa kaaran bunn sakate hain. iss pareekshan mein achchi samvedansheelta aur vishishtata haye.
aamtaur parr caroted stenosis mein nirnay lene key liye duplexes ultrasound scan ekmatra aavashyak jaanch haye kyonki yeh vyaapak roop seey upalabdh haye aur teji seey kiya jaataa haye. haalaanki, yadi stenosis caroted dhamani key vibhajan key karib naheen haye tou aage kii imaging kii aavashyakta hoe sakati haye.
kaee alag-alag imaging taur-tarikon mein seey ack, jaise kii computed tomography angiogram (see. tii. aeye.) yaa magnetic resonance angiogram (aim. aar. aeye.) upayogi hoe sakata haye. pratyek imaging modality key apane faayade aur nuksan hain-magnetic resonance angiography aur ct angiography isake vipareet purani gurde kii bimari vaale rogiyon mein virodhabhasi haye, catheter angiography mein stroke, aim. aaee., dhamani kii chot yaa retroperitoneal raktasraav kaa 0.5% seey 1.0% jokhim hotaa haye. chuni gaee jaanch naidaanik prashn aur upalabdh imaging visheshagyata, anubhav aur upkaran parr nirbhar karegi.
upchaar key uddeshya seey, caroted stenosis kii degree koo iss prakaar paribhaashit kiya gayaa haih
screening.
yuu.aiss. nivaarak seva kaary bull (yuu. aiss. pee. aiss. tii. aff.) 2021 taka binaa lakshnon vaale logon mein caroted dhamani stenosis key liye niyamit jaanch key khilaf sifarish kartaa haye.
jabaki niyamit jansankhya jaanch kii salah naheen dee jaati haye, american haart association aur society forr vascular sergery una logon mein jaanch kii salah dete hain joe sambandhit chikitsa sthitiyon seey peedit hain yaa jinamen caroted dhamani roga key liye jokhim kaarak hain. jinn logon key paas haih
american haart association yeh bhee anushansa kartaa haye kii yadi koee chikitsak shaaririk pariksha key dauran stethoscope key madhyam seey sunkar caroted dhamani key oopar caroted phal, yaa budd budd kaa pataa lagaata haye. lakshnon vaale logon key liye, american haart association ultrasound kaa upayog karke praarambhik jaanch kii sifarish kartaa haye.
upchaar.
caroted dhamani stenosis key ilaaj kaa lakshya stroke key jokhim koo cumm karna haye. upchaar kaa prakaar roga kii gambhirta parr nirbhar kartaa haye aur isamen shamil hainh
dawa.
naidaanik dishanirdesh (jaise kii american haart association (aeye. aich. aeye.) aur national institute forr clinical axilance (nice)) anushansa karate hain kii caroted stenosis vaale sabhi rogiyon koo unake samvahani jokhim karakon koo niyantrit karane key liye davaaen dee jaaen, aamtaur parr raktchaap koo cumm karane vaali davaaen (yadi unhein uchch raktchaap haye), madhumeh kii davaaen (yadi unhein madhumeh haye), aur vyayam, vajan mein kamee (yadi adhik vajan haye) aur dhumrapan bund karane (dhumrapan karane vaalon key liye) kii anushansa karate hain. isake alawa, way anty-platelet davaaon (jaise aspirin yaa clopidograil) aur collestroll koo cumm karane vaali davaaon (jaise statin, joe mool roop seey unake collestroll koo cumm karane vaale prabhaavon key liye nirdhaarit kiye gaye they, lekin soojan koo cumm karane aur pattika koo sthir karane key liye bhee paae gaye they) seey labhanvit honge.
punarsanchaalit karna.
american haart association key anusaar, chikitsa prabandhan seey parey hastakshep iss baat parr adharit haye kii kyaa rogiyon mein lakshan hainh
caroted revascularization (caroted endarterectomy, caroted stenting, aur transcaroted dhamani revascularization) key liye sabhi hastakshepon mein stroke kaa kuchh jokhim hotaa haye; haalaanki, jahaan akele chikitsa prabandhan seey samay key saath stroke kaa jokhim adhik hotaa haye, hastakshep fayademand hoe sakata haye. caroted dhamani stenosis kii gambhir degree vaale rogiyon mein caroted dhamani stenting aur caroted endarterectomy key samaan laabh paae gaye hain.

