Kalp damar tedavisinde y\u0131llard\u0131r en iyi bilinen y\u00f6ntem stentleme y\u00f6ntemi.
Ama son y\u0131llarda yeni bir soru giderek daha s\u0131k soruluyor:
\ud83d\udc49 \u201cArt\u0131k stent takmadan damar a\u00e7mak m\u00fcmk\u00fcn m\u00fc?\u201d
Cevap: Baz\u0131 durumlarda evet. Ama her hasta i\u00e7in de\u011fil.
\u0130la\u00e7 kapl\u0131 balon (DCB) nedir? \u0130lac Kapl\u0131 Balon (Drug Coated Balloon – DCB), genellikle ila\u00e7 sal\u0131n\u0131ml\u0131 balon (DEB) olarak da adland\u0131r\u0131l\u0131r; daralm\u0131\u015f (stenotik) arterleri geni\u015fletmek i\u00e7in tasarlanm\u0131\u015f \u00f6zel bir anjiyoplasti kateteridir. Bu i\u015flem s\u0131ras\u0131nda, damar\u0131n tekrar daralmas\u0131n\u0131 \u00f6nlemek amac\u0131yla antiproliferatif bir ilac\u0131 (paklitaksel gibi) do\u011frudan damar duvar\u0131na salar. “Geride hi\u00e7bir \u015fey b\u0131rakmama” konseptiyle \u00e7al\u0131\u015fan bu y\u00f6ntem, stentler gibi kal\u0131c\u0131 metal implantlar\u0131n kullan\u0131m\u0131ndan ka\u00e7\u0131n\u0131r.
\u0130la\u00e7 kapl\u0131 balonlar, damar i\u00e7ine yerle\u015ftirilen klasik stentlerden farkl\u0131 olarak:
\u2714\ufe0f Damara metal b\u0131rakmaz
\u2714\ufe0f Sadece k\u0131sa s\u00fcreli \u015fi\u015firilir.
\u2714\ufe0f \u00dczerindeki ila\u00e7 (paklitaksel veya sirolimus) damar duvar\u0131na ge\u00e7er.<\/p>\n\n\n\n
\ud83d\udd2c Bilim ne diyor? (G\u00fcncel veriler)
Son y\u0131llarda yap\u0131lan randomize \u00e7al\u0131\u015fmalar ve meta-analizler:
\ud83d\udcca 1. K\u00fc\u00e7\u00fck damar hastal\u0131\u011f\u0131nda:
\u2022\u2060 \u2060DCB \u2248 stent kadar etkili
\u2022\u2060 \u2060Restenoz oranlar\u0131 benzer
\ud83d\udcca 2. Stent i\u00e7i yeniden daralma (ISR):
\u2022\u2060 \u2060DCB birinci se\u00e7eneklerden biri
\u2022\u2060 \u2060Tekrar stent koymadan tedavi imkan\u0131
\ud83d\udcca 3. B\u00fcy\u00fck damar \/ kompleks lezyonlar:
\u2022\u2060 \u2060Stent hala daha g\u00fc\u00e7l\u00fc ve g\u00fcvenilir se\u00e7enek
\ud83d\udca1 \u00d6zet bilimsel ger\u00e7ek:
\ud83d\udc49 DCB baz\u0131 alanlarda e\u015fde\u011fer
\ud83d\udc49 Ama hen\u00fcz genel bir alternatif de\u011fil ve t\u00fcm damar tiplerinde (\u00f6zellikle b\u00fcy\u00fck do\u011fal damarlarda) uygulanmalar\u0131 i\u00e7in daha fazla veriye ihtiya\u00e7 var.<\/p>\n\n\n\n
\u2696\ufe0f Avantajlar\u0131 neler?
\u2714\ufe0f Damarda kal\u0131c\u0131 metal yok
\u2714\ufe0f Daha do\u011fal damar hareketi
\u2714\ufe0f Daha k\u0131sa s\u00fcreli kan suland\u0131r\u0131c\u0131 ihtiyac\u0131
\u2714\ufe0f \u00d6zellikle gen\u00e7 hastalarda ve kalp d\u0131\u015f\u0131 b\u00fcy\u00fck ameliyat uygulanacak ve kan suland\u0131r\u0131c\u0131 tedavisine ara verilmesi gereken hastalarda avantaj
Dezavantajlar\u0131 \/ s\u0131n\u0131rlamalar\u0131
\u274c Her damarda uygulanamaz
\u274c Teknik ba\u015far\u0131 \u00e7ok \u00f6nemli
\u274c Damar\u0131n iyi haz\u0131rlanmas\u0131 \u015fart
\u274c Baz\u0131 durumlarda yine stent gerekebilir<\/p>\n\n\n\n
\u2753 Kimler i\u00e7in uygun?
\ud83d\udc49 En uygun hastalar:
\u2714\ufe0f K\u00fc\u00e7\u00fck damar hastal\u0131\u011f\u0131
\u2714\ufe0f Stent i\u00e7i daralma (ISR)
\u2714\ufe0f Kan suland\u0131r\u0131c\u0131y\u0131 uzun s\u00fcre kullanamayanlar<\/p>\n\n\n\n
\u2753 Kimlerde stent h\u00e2l\u00e2 vazge\u00e7ilmez?
\u2714\ufe0f B\u00fcy\u00fck damar hastal\u0131\u011f\u0131
\u2714\ufe0f Kire\u00e7li (kalsifik) lezyonlar
\u2714\ufe0f Kompleks darl\u0131klar
\u2714\ufe0f Akut kalp krizi<\/p>\n\n\n\n
Modern yakla\u015f\u0131m: \u201cLeave Nothing Behind\u201d
G\u00fcncel kardiyolojide yeni bir konsept var:
\ud83d\udc49 \u201cDamarda m\u00fcmk\u00fcnse hi\u00e7bir \u015fey b\u0131rakma\u201d
Ama bu yakla\u015f\u0131m:
\u2714\ufe0f Do\u011fru hasta
\u2714\ufe0f Do\u011fru lezyon
\u2714\ufe0f Deneyimli operat\u00f6r
gerektirir<\/p>\n\n\n\n
EN KR\u0130T\u0130K NOKTA
DCB bir \u201cstent alternatifi\u201d de\u011fil, do\u011fru hastada kullan\u0131lan g\u00fc\u00e7l\u00fc bir ara\u00e7t\u0131r.<\/p>\n\n\n\n
SONU\u00c7
\u274c Stent devri kapanm\u0131yor
\u2714\ufe0f Ama art\u0131k tek se\u00e7enek de\u011fil
\ud83d\udc49 Tedavi art\u0131k \u015funa d\u00f6n\u00fc\u015f\u00fcyor:
\u201cHerkese stent de\u011fil, hastaya \u00f6zel \u00e7\u00f6z\u00fcm\u201d<\/p>\n\n\n\n
\u201cGelecekte hedef; damar\u0131 sadece a\u00e7mak de\u011fil,
en az m\u00fcdahale ile en do\u011fal haliyle b\u0131rakmak.\u201d<\/p>\n\n\n\n
<\/p>","protected":false},"excerpt":{"rendered":"
Kalp damar tedavisinde y\u0131llard\u0131r en iyi bilinen y\u00f6ntem stentleme y\u00f6ntemi.Ama son y\u0131llarda yeni bir soru giderek daha s\u0131k soruluyor:\ud83d\udc49 \u201cArt\u0131k stent takmadan damar a\u00e7mak m\u00fcmk\u00fcn m\u00fc?\u201dCevap: Baz\u0131 durumlarda evet. Ama her hasta i\u00e7in de\u011fil.\u0130la\u00e7 kapl\u0131 balon (DCB) nedir? \u0130lac Kapl\u0131 Balon (Drug Coated Balloon – DCB), genellikle ila\u00e7 sal\u0131n\u0131ml\u0131 balon (DEB) olarak da adland\u0131r\u0131l\u0131r; daralm\u0131\u015f […]<\/p>\n","protected":false},"author":2,"featured_media":8075,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8074","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-dental-services"],"_links":{"self":[{"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/posts\/8074","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/comments?post=8074"}],"version-history":[{"count":2,"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/posts\/8074\/revisions"}],"predecessor-version":[{"id":8077,"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/posts\/8074\/revisions\/8077"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/media\/8075"}],"wp:attachment":[{"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/media?parent=8074"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/categories?post=8074"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/alibuturak.com\/en\/wp-json\/wp\/v2\/tags?post=8074"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}