{"id":2577,"date":"2020-08-26T10:34:44","date_gmt":"2020-08-26T10:34:44","guid":{"rendered":"http:\/\/tell.agency\/medcom\/?page_id=2577"},"modified":"2023-04-10T18:29:20","modified_gmt":"2023-04-10T18:29:20","slug":"chirurgie-vasculara","status":"publish","type":"page","link":"https:\/\/medcom.ro\/index.php\/chirurgie-vasculara\/","title":{"rendered":"Chirurgie vascular\u0103"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: #ffffff;background-position: center top;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:calc( 1200px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><style type=\"text\/css\">@media only screen and (max-width:1024px) {.fusion-title.fusion-title-1{margin-top:0px!important; margin-right:0px!important;margin-bottom:0px!important;margin-left:0px!important;}}@media only screen and (max-width:640px) {.fusion-title.fusion-title-1{margin-top:0px!important; margin-right:0px!important;margin-bottom:20px!important; margin-left:0px!important;}}<\/style><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-two\" style=\"margin-top:0px;margin-right:0px;margin-bottom:0px;margin-left:0px;\"><h2 class=\"title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:30;line-height:1.25;\">Chirurgie vascular\u0103<\/h2><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;margin-bottom:30px;width:100%;\"><div class=\"fusion-separator-border sep-shadow\" style=\"background:radial-gradient(ellipse at 50% -50% , #e2e2e2 0px, rgba(255, 255, 255, 0) 80%) repeat scroll 0 0 rgba(0, 0, 0, 0);background:-webkit-radial-gradient(ellipse at 50% -50% , #e2e2e2 0px, rgba(255, 255, 255, 0) 80%) repeat scroll 0 0 rgba(0, 0, 0, 0);background:-moz-radial-gradient(ellipse at 50% -50% , #e2e2e2 0px, rgba(255, 255, 255, 0) 80%) repeat scroll 0 0 rgba(0, 0, 0, 0);background:-o-radial-gradient(ellipse at 50% -50% , #e2e2e2 0px, rgba(255, 255, 255, 0) 80%) repeat scroll 0 0 rgba(0, 0, 0, 0);\"><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:30px;width:100%;\"><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-0{width:100% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-0 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 0px;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 0px;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-0{width:100% !important;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 0px;margin-left : 0px;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-0{width:100% !important;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 0px;margin-left : 0px;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-1{ padding-top : 10%;margin-top : 0px;padding-right : 5%;padding-bottom : 0%;margin-bottom : 0px;padding-left : 5%;}<\/style><\/div><div id=\"chirurgievasculara\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-no-small-visibility fusion-no-medium-visibility\" style=\"background-color: rgba(255,255,255,0);background-position: center top;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-stretch\" style=\"max-width:calc( 1200px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-tabs fusion-tabs-1 clean vertical-tabs icon-position-left\"><style type=\"text\/css\">#wrapper .fusion-tabs.fusion-tabs-1.clean .nav-tabs li a.tab-link{border-color:#d5a748;}.fusion-tabs.fusion-tabs-1 .nav-tabs li a.tab-link{background-color:#d5a748;}.fusion-tabs.fusion-tabs-1 .nav-tabs li.active a.tab-link,.fusion-tabs.fusion-tabs-1 .nav-tabs li.active a.tab-link:hover,.fusion-tabs.fusion-tabs-1 .nav-tabs li.active a.tab-link:focus{background-color:#ffffff;}.fusion-tabs.fusion-tabs-1 .nav-tabs li a:hover{background-color:#ffffff;border-top-color:#ffffff;}.fusion-tabs.fusion-tabs-1 .tab-pane{background-color:#ffffff;}.fusion-tabs.fusion-tabs-1 .nav,.fusion-tabs.fusion-tabs-1 .nav-tabs,.fusion-tabs.fusion-tabs-1 .tab-content .tab-pane{border-color:#d5a748;}<\/style><div class=\"nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li class=\"active\" role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-d72a0d2ce8b1beecd37\" aria-selected=\"true\" id=\"fusion-tab-tratamentulvaricelorprinmetodac.h.i.v.a\" href=\"#tab-d72a0d2ce8b1beecd37\"><h4 class=\"fusion-tab-heading\">Tratamentul varicelor prin metoda C.H.I.V.A<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-f369810210ec04f39ab\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-flebectomiilepentruvarice\" href=\"#tab-f369810210ec04f39ab\"><h4 class=\"fusion-tab-heading\">Flebectomiile pentru varice<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-f10080e50717a626a95\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-bypassularterial\" href=\"#tab-f10080e50717a626a95\"><h4 class=\"fusion-tab-heading\">Bypassul arterial<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-1baa050c1e4110616ec\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-endarterectomiacarotidian\u0103\" href=\"#tab-1baa050c1e4110616ec\"><h4 class=\"fusion-tab-heading\">Endarterectomia Carotidian\u0103<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-b2255b2a16a1c1468be\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-endarterectomiafemural\u0103\" href=\"#tab-b2255b2a16a1c1468be\"><h4 class=\"fusion-tab-heading\">Endarterectomia femural\u0103<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-e181842bd1ebf966572\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-embolectomiaarterial\u0103\" href=\"#tab-e181842bd1ebf966572\"><h4 class=\"fusion-tab-heading\">Embolectomia arterial\u0103<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-0910dbe2e91d2f2e0e3\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-accesulvascularpentruhemodializ\u0103\" href=\"#tab-0910dbe2e91d2f2e0e3\"><h4 class=\"fusion-tab-heading\">Accesul vascular pentru hemodializ\u0103<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-9d97b21c75c01295578\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-accesulvascularpentruchimioterapie\" href=\"#tab-9d97b21c75c01295578\"><h4 class=\"fusion-tab-heading\">Accesul vascular pentru chimioterapie<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-content\"><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li class=\"active\" role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-d72a0d2ce8b1beecd37\" aria-selected=\"true\" id=\"mobile-fusion-tab-tratamentulvaricelorprinmetodac.h.i.v.a\" href=\"#tab-d72a0d2ce8b1beecd37\"><h4 class=\"fusion-tab-heading\">Tratamentul varicelor prin metoda C.H.I.V.A<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix in active\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-tratamentulvaricelorprinmetodac.h.i.v.a\" id=\"tab-d72a0d2ce8b1beecd37\">\n<p><strong>Chirurgia varicelor membrelor inferioare\u00a0<\/strong><\/p>\n<p>Ave\u021bi picioarele afectate de varice? Tratamentul v\u0103 este la \u00eendem\u00e2n\u0103! \u00cen clinica CBS Medcom, Dr. George P\u0103tru\u021b utilizeaz\u0103 tehnica CHIVA, o procedur\u0103 minim invaziv\u0103, folosit\u0103 uzual \u00een Fran\u021ba, pentru a v\u0103 elimina \u00een siguran\u021b\u0103 aceste dilata\u021bii venoase inestetice.<\/p>\n<p>De ce apar varicele?<\/p>\n<p>Varicele afecteaz\u0103 cel pu\u021bin unul din zece adul\u021bi. Cauza lor exact\u0103 este necunoscut\u0103, consider\u00e2ndu-se c\u0103 reprezint\u0103 o boal\u0103 a peretelui venos mo\u0219tenit\u0103. Exist\u0103 \u0219i factori agravan\u021bi: statul prelungit \u00een picioare, excesul de greutate, stilul de via\u021b\u0103 sedentar, c\u0103ldura, sarcina. Aceast\u0103 modificare progresiv\u0103 a peretelui venos este ireversibil\u0103 \u0219i determin\u0103 un reflux venos de sus \u00een jos, accentu\u00e2nd \u00een timp dilat\u0103rile varicoase.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Chirurgie vascular\u0103 Timi\u0219oara\" title=\"varice\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/varice-400x304.jpg\" class=\"img-responsive wp-image-2600\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este tehnica CHIVA?<\/p>\n<p>CHIVA reprezint\u0103 acronimul numelui procedurii &#8211; Cura Hemodinamic\u0103 a Insuficien\u021bei Venoase \u00een Ambulator. Principiul de baz\u0103 al interven\u021biei este ligaturarea venelor incontinente \u0219i \u00eendep\u0103rtarea pachetelor varicoase (flebectomii). Astfel se elimin\u0103 factorul cauzator al bolii varicoase \u0219i anume presiunea crescut\u0103 din sistemul venos superficial. Interven\u021bia este minim invaziv\u0103, inciziile sunt discrete \u0219i are acelea\u0219i efecte ca opera\u021bia clasic\u0103, \u00een care vena este smuls\u0103 din membrul inferior. Beneficiile sunt majore: durere minim\u0103 dup\u0103 opera\u021bie, lipsa s\u00e2nger\u0103rilor, risc foarte mic de infec\u021bie, reluarea imediat\u0103 a activit\u0103\u021bilor obi\u0219nuite<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-2 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Opera\u021bie varice\" title=\"varice 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/varice-2-400x304.jpg\" class=\"img-responsive wp-image-2599\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<ul>\n<li>Rezultatele finale pot fi apreciate la 3 s\u0103pt\u0103m\u00e2ni dup\u0103 interven\u021bie;<\/li>\n<li>Principalul beneficiu &#8211; dispari\u021bia dilata\u021biilor varicoase, cu efect de durat\u0103;<\/li>\n<li>Ameliorarea semnificativ\u0103 a simptomelor produse de varice: umflarea picioarelor, senza\u021bia de tensiune \u00een gambe, amor\u021beli;<\/li>\n<li>Men\u021binerea pe termen lung a rezultatelor depinde \u0219i de adoptarea unui stil de via\u021b\u0103 activ, purtarea ciorapilor elastici \u0219i p\u0103strarea greut\u0103\u021bii corporale \u00een limite normale.<\/li>\n<\/ul>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-f369810210ec04f39ab\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-flebectomiilepentruvarice\" href=\"#tab-f369810210ec04f39ab\"><h4 class=\"fusion-tab-heading\">Flebectomiile pentru varice<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-flebectomiilepentruvarice\" id=\"tab-f369810210ec04f39ab\">\n<p><strong>Flebectomiile pentru varice<\/strong><\/p>\n<p><strong>\u00a0<\/strong>\u00cen cazul \u00een care boala venoas\u0103 cronic\u0103 nu este extrem de avansat\u0103 \u0219i sunt prezente doar c\u00e2teva dilata\u021bii varicoase, acestea pot fi operate prin flebectomii.<\/p>\n<p>De ce apar varicele?<\/p>\n<p>Varicele afecteaz\u0103 cel pu\u021bin unul din zece adul\u021bi. Cauza lor exact\u0103 este necunoscut\u0103, consider\u00e2ndu-se c\u0103 reprezint\u0103 o boal\u0103 a peretelui venos mo\u0219tenit\u0103. Exist\u0103 \u0219i factori agravan\u021bi: statul prelungit \u00een picioare, excesul de greutate, stilul de via\u021b\u0103 sedentar, c\u0103ldura, sarcina. Aceast\u0103 modificare progresiv\u0103 a peretelui venos este ireversibil\u0103 \u0219i determin\u0103 un reflux venos de sus \u00een jos, accentu\u00e2nd \u00een timp dilat\u0103rile varicoase.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-3 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Chirurgie vascular\u0103 Timi\u0219oara\" title=\"varice\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/varice-400x304.jpg\" class=\"img-responsive wp-image-2600\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce sunt flebectomiile?<\/p>\n<p>Pentru a trata dilata\u021biile varicoase, chirurgul \u00een\u021beap\u0103 pielea cu v\u00eerful bisturiului \u0219i, prin aceast\u0103 mini incizie, aga\u021b\u0103 vena dilatat\u0103 cu un instrument special, apoi o extrage. La final, inciziile nu sunt suturate cu fire, ci cu c\u00e2teva benzi elastice adezive, care apropie \u0219i \u021bin lipite marginile pielii.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-4 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Flebectomie\" title=\"flebectomie\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/flebectomie-400x304.jpg\" class=\"img-responsive wp-image-2666\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<ul>\n<li>Rezultatele finale pot fi apreciate la 3 s\u0103pt\u0103m\u00e2ni dup\u0103 interven\u021bie;<\/li>\n<li>Principalul beneficiu &#8211; dispari\u021bia dilata\u021biilor varicoase, cu efect de durat\u0103;<\/li>\n<li>Ameliorarea semnificativ\u0103 a simptomelor produse de varice: umflarea picioarelor, senza\u021bia de tensiune \u00een gambe, amor\u021beli;<\/li>\n<li>Men\u021binerea pe termen lung a rezultatelor depinde \u0219i de adoptarea unui stil de via\u021b\u0103 activ, purtarea ciorapilor elastici \u0219i p\u0103strarea greut\u0103\u021bii corporale \u00een limite normale.<\/li>\n<\/ul>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-f10080e50717a626a95\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-bypassularterial\" href=\"#tab-f10080e50717a626a95\"><h4 class=\"fusion-tab-heading\">Bypassul arterial<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-bypassularterial\" id=\"tab-f10080e50717a626a95\">\n<p><strong>Bypass-ul arterial<\/strong><\/p>\n<p>Boala arterelor membrelor inferioare reprezint\u0103 \u00eengustarea, sau chiar blocarea total\u0103 a acestora. Astfel s\u00e2ngele nu mai ajunge \u00eentr-o cantitate suficient\u0103 \u00een zonele de sub blocaj.<\/p>\n<p>Este o boal\u0103 cronic\u0103, care se agraveaz\u0103 odat\u0103 cu trecerea timpului, produc\u00e2nd simptome din ce \u00een ce mai intense &#8211; ini\u021bial durere la mers, apoi durere \u0219i la repaus \u0219i, \u00een final, leziuni trofice ale pielii &#8211; necroze \u0219i gangrene.<\/p>\n<p>De ce se \u00eemboln\u0103vesc arterele?<\/p>\n<p>Aceast\u0103 boal\u0103 este cauzat\u0103 de formarea de pl\u0103ci de aterom \u00een arterele care duc s\u00e2nge \u00een picior. Pl\u0103cile de aterom sunt aglomer\u0103ri de colesterol, calciu, \u021besut fibros \u0219i alte resturi celulare care se acumuleaz\u0103 \u00een pere\u021bii arterei. Procesul se nume\u0219te ateroscleroz\u0103. Pl\u0103cile ateromatoase se dezvolt\u0103 \u00een principal din cauza turbulen\u021belor fluxului sanguin, ap\u0103rute mai ales la bifurca\u021biile arteriale \u0219i sunt agravate de factorii de risc cardiovascular: tutun, hipertensiune arterial\u0103, anomalii lipidice (excesul de colesterol), diabet \u0219i \u00eemb\u0103tr\u00e2nire.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-5 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Bypass arterial\" title=\"bypassul arterial\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/bypassul-arterial-400x304.jpg\" class=\"img-responsive wp-image-2669\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Cum se manifest\u0103 boala arterial\u0103 periferic\u0103?<\/p>\n<p>Manifest\u0103rile clinice sunt legate de gradul de \u00eengustare a arterei \u0219i sunt clasificate \u00een trei stadii de cre\u0219tere a severit\u0103\u021bii:<\/p>\n<ol>\n<li>Durerile de efort: sunt dureri asem\u0103n\u0103toare cu crampele musculare sau se pot manifesta ca o senza\u021bie de oboseal\u0103 a anumitor grupe musculare (coapse, gambe). Aceste dureri sunt declan\u0219ate de efort \u0219i dispar dup\u0103 repaus. Ele apar \u00een timpul mersului pe jos, niciodat\u0103 \u00een repaus sau la simplul stat \u00een picioare. Distan\u021ba parcurs\u0103 \u00eenainte de apari\u021bia durerii (perimetrul de mers pe jos) poate varia de la c\u00e2\u021biva metri la mai mult de 500 de metri \u0219i este un bun indicator al severit\u0103\u021bii bolii.<\/li>\n<li>Durerile de repaus: sunt mai ales nocturne, intense, adesea intolerabile, localizate la nivelul degetelor sau piciorului. Aceste dureri sunt asociate cu extremit\u0103\u021bi reci. \u00cei for\u021beaz\u0103 pe pacient s\u0103 se ridice sau s\u0103-\u0219i at\u00e2rne picioarele la marginea patului, apoi cedeaz\u0103 treptat. Aceste dureri reflect\u0103 un grad avansat al bolii \u0219i necesit\u0103 consiliere medical\u0103 urgent\u0103 \u00eenainte de apari\u021bia leziunilor ulcerative sau a gangrenei.<\/li>\n<li>Apari\u021bia pl\u0103gilor sau a gangrenei (ultimul stadiu de evolu\u021bie) poate antrena pierderea membrului inferior.<\/li>\n<\/ol>\n<p>Ce este bypass-ul arterial?<\/p>\n<p>Opera\u021bia const\u0103 \u00een ocolirea segmentului bolnav al arterei. \u00cen acest scop, chirurgul recolteaz\u0103 vena safen\u0103 mare, care este vena cea mai lung\u0103 a piciorului \u0219i o conecteaz\u0103 la arter\u0103 deasupra \u0219i sub zona bolnav\u0103. Astfel, s\u00e2ngele este deviat prin ven\u0103 \u0219i ocole\u0219te segmentul arterial bolnav. \u00cen cazul \u00een care vena pacientului este prea sub\u021bire \u0219i nu poate fi folosit\u0103, se utilizeaz\u0103 o protez\u0103 din material sintetic.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-6 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Bypass arterial\" title=\"bypassul arterial 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-400x304.jpg\" class=\"img-responsive wp-image-2668\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<p>Rezultatele pe termen lung ale acestei opera\u021bii sunt excelente. Un bypass cu ven\u0103 poate r\u0103m\u00e2ne func\u021bional mai mult de 20 de ani, dac\u0103 factorii de risc ai aterosclerozei sunt bine controla\u021bi &#8211; renun\u021bare la fumat, controlul tensiunii arteriale, al diabetului \u0219i colesterolului.<\/p>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-1baa050c1e4110616ec\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-endarterectomiacarotidian\u0103\" href=\"#tab-1baa050c1e4110616ec\"><h4 class=\"fusion-tab-heading\">Endarterectomia Carotidian\u0103<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-endarterectomiacarotidian\u0103\" id=\"tab-1baa050c1e4110616ec\">\n<p><strong>Endarterectomia carotidian\u0103<\/strong><\/p>\n<p>\u00cengustarea \u0219i calcificarea arterelor carotide\u00a0 reprezint\u0103 o boal\u0103 extrem de serioas\u0103, care poate avea consecin\u021be majore, cea mai periculoas\u0103 fiind accidentul vascular cerebral. Acesta este o urgen\u021b\u0103 medical\u0103 imediat\u0103, alimentarea cu s\u00e2nge a creierului fiind \u00eentrerupt\u0103 sau redus\u0103 brusc.<\/p>\n<p>Cum apare boala carotidian\u0103?<\/p>\n<p>Boala arterei carotide este cauzat\u0103 de acumularea de pl\u0103ci de aterom \u00een arterele care duc s\u00e2nge \u00een creier. Pl\u0103cile de aterom sunt aglomer\u0103ri de colesterol, calciu, \u021besut fibros \u0219i alte resturi celulare care se acumuleaz\u0103 \u00een pere\u021bii arterei. Acest proces se nume\u0219te ateroscleroz\u0103. Arterele carotide care sunt afectate de ateroscleroz\u0103 devin rigide \u0219i \u00eengustate \u0219i au dificult\u0103\u021bi \u00een a furniza oxigen \u0219i substan\u021be nutritive structurilor vitale din creier care sunt responsabile pentru func\u021bionarea zilnic\u0103 a organismului.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-7 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"endarterectomie\" title=\"endarterectomie\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/endarterectomie-400x304.jpg\" class=\"img-responsive wp-image-2613\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este endarterectomia carotidian\u0103?<\/p>\n<p>Scopul tratamentului bolii arterei carotide este de a preveni accidentul vascular cerebral. Acesta se produce atunci c\u00e2nd buc\u0103\u021bi din pl\u0103cile de aterom din artera bolnav\u0103 se desprind \u0219i sunt purtate de s\u00e2nge \u00een creier, unde \u00eenfund\u0103 vasele locale, astfel c\u0103 acea por\u021biune din creier nu mai prime\u0219te s\u00e2nge \u0219i oxigen. Pentru a extrage aceste pl\u0103ci de aterom, chirurgul face o incizie de 10-15 cm pe partea lateral\u0103 a g\u00e2tului, disec\u0103 artera de structurile \u00eenconjur\u0103toare, o deschide \u0219i o cur\u0103\u021b\u0103, apoi coase un petec din material sintetic pentru a o l\u0103rgi. Opera\u021bia se realizeaz\u0103 \u00een anestezie local\u0103 \u0219i necesit\u0103 o perioad\u0103 de spitalizare de 3-4 zile.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-8 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"endarterectomie carotidiana\" title=\"endarterectomie carotidiana\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-400x304.jpg\" class=\"img-responsive wp-image-2612\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<p>Rezultatele endarterectomiei carotidiene sunt, \u00een general, foarte satisf\u0103c\u0103toare. Cu toate acestea exist\u0103 un risc de re-\u00eengustare comun tuturor interven\u021biilor asupra sistemului arterial, legat de o &#8222;cicatrizare&#8221; rea a arterei. Acest fenomen poate ap\u0103rea \u00een cursul primului an, mecanismul \u0219i prevenirea acestuia nefiind momentan cunoscute.<\/p>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-b2255b2a16a1c1468be\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-endarterectomiafemural\u0103\" href=\"#tab-b2255b2a16a1c1468be\"><h4 class=\"fusion-tab-heading\">Endarterectomia femural\u0103<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-endarterectomiafemural\u0103\" id=\"tab-b2255b2a16a1c1468be\">\n<p><strong>Endarterectomia femural\u0103<\/strong><\/p>\n<p><strong>\u00a0<\/strong>\u201cButuruga mic\u0103 r\u0103stoarn\u0103 carul mare\u201d, un proverb vechi care se aplic\u0103 perfect \u00een cazul bolii arterelor femurale. Artera femural\u0103 comun\u0103 este o arter\u0103 scurt\u0103, de 4-5 cm, situat\u0103 la baza piciorului, care se \u00eemparte \u00een dou\u0103 ramuri. Prima, artera femurala profund\u0103, transport\u0103 s\u00e2ngele c\u0103tre mu\u0219chii coapsei, iar cea de-a doua, artera femural\u0103 superficial\u0103, coboar\u0103 p\u00e2n\u0103 sub genunchi, unde deserve\u0219te mu\u0219chii gambei. Astfel c\u0103, \u00eemboln\u0103virea acestei artere are repercursiuni asupra circula\u021biei \u00eentregului membru inferior.<\/p>\n<p>De ce se \u00eemboln\u0103vesc arterele?<\/p>\n<p>Boala arterelor reprezint\u0103, de fapt, formarea de pl\u0103ci de aterom \u00een pere\u021bii acestora. Pl\u0103cile de aterom sunt aglomer\u0103ri de colesterol, calciu, \u021besut fibros \u0219i alte resturi celulare care se acumuleaz\u0103 \u00een timp \u0219i \u00eengusteaz\u0103 vasul. Procesul se nume\u0219te ateroscleroz\u0103. Pl\u0103cile ateromatoase se dezvolt\u0103 \u00een principal din cauza turbulen\u021belor fluxului sanguin, ap\u0103rute mai ales la bifurca\u021biile arteriale \u0219i sunt agravate de factorii de risc cardiovascular: tutun, hipertensiune arterial\u0103, anomalii lipidice (excesul de colesterol), diabet \u0219i \u00eemb\u0103tr\u00e2nire.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-9 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Bypass arterial\" title=\"bypassul arterial\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/bypassul-arterial-400x304.jpg\" class=\"img-responsive wp-image-2669\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Cum se manifest\u0103 boala arterial\u0103 periferic\u0103?<\/p>\n<p>Manifest\u0103rile clinice sunt legate de gradul de \u00eengustare a arterei \u0219i sunt clasificate \u00een trei stadii de cre\u0219tere a severit\u0103\u021bii:<\/p>\n<ol>\n<li>Durerile de efort: sunt dureri asem\u0103n\u0103toare cu crampele musculare sau se pot manifesta ca o senza\u021bie de oboseal\u0103 a anumitor grupe musculare (coapse, gambe). Aceste dureri sunt declan\u0219ate de efort \u0219i dispar dup\u0103 repaus. Ele apar \u00een timpul mersului pe jos, niciodat\u0103 \u00een repaus sau la simplul stat \u00een picioare. Distan\u021ba parcurs\u0103 \u00eenainte de apari\u021bia durerii (perimetrul de mers pe jos) poate varia de la c\u00e2\u021biva metri la mai mult de 500 de metri \u0219i este un bun indicator al severit\u0103\u021bii bolii.<\/li>\n<li>Durerile de repaus: sunt mai ales nocturne, intense, adesea intolerabile, localizate la nivelul degetelor sau piciorului. Aceste dureri sunt asociate cu extremit\u0103\u021bi reci. \u00cei for\u021beaz\u0103 pe pacient s\u0103 se ridice sau s\u0103-\u0219i at\u00e2rne picioarele la marginea patului, apoi cedeaz\u0103 treptat. Aceste dureri reflect\u0103 un grad avansat al bolii \u0219i necesit\u0103 consiliere medical\u0103 urgent\u0103 \u00eenainte de apari\u021bia leziunilor ulcerative sau a gangrenei.<\/li>\n<li>Apari\u021bia pl\u0103gilor sau a gangrenei (ultimul stadiu de evolu\u021bie) poate antrena pierderea membrului inferior.<\/li>\n<\/ol>\n<p>Ce este endarterectomia femural\u0103?<\/p>\n<p>Opera\u021bia se realizeaz\u0103, de obicei, \u00een anestezie local\u0103. Scopul interven\u021biei este restabilirea circula\u021biei prin \u00eendep\u0103rtarea pl\u0103cilor de aterom. Printr-o incizie de 5-6 cm, chirurgul deschide artera \u0219i extrage cu un instrument special toate pl\u0103cile ateromatoase. La final, artera este l\u0103rgit\u0103 prin suturarea unui petec croit dintr-o ven\u0103 recoltat\u0103 de deasupra gleznei.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-10 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Chirurgie vascular\u0103 Timi\u0219oara\" title=\"femurala\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/femurala-400x304.jpg\" class=\"img-responsive wp-image-2671\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<p>Pentru c\u0103 artera femural\u0103 se g\u0103se\u0219te aproape de piele \u0219i incizia este scurt\u0103, recuperarea este rapid\u0103, cu un disconfort dureros mic, doar \u00een primele dou\u0103 zile. Dac\u0103 pacientul ader\u0103 la stilul de via\u021b\u0103 recomandat de medic, cu un control strict al factorilor de risc &#8211; renun\u021barea la fumat, controlul tensiunii arteriale, al diabetului \u0219i colesterolului &#8211; efectele benefice produse de interven\u021bie se vor manifesta pe perioad\u0103 \u00eendelungat\u0103, de zeci de ani.<\/p>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-e181842bd1ebf966572\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-embolectomiaarterial\u0103\" href=\"#tab-e181842bd1ebf966572\"><h4 class=\"fusion-tab-heading\">Embolectomia arterial\u0103<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-embolectomiaarterial\u0103\" id=\"tab-e181842bd1ebf966572\">\n<p><strong>Embolectomia arterial\u0103<\/strong><\/p>\n<p>Un embol este un cheag de s\u00e2nge care s-a format \u00eentr-o zon\u0103 a organismului \u0219i a fost purtat de s\u00e2nge \u00een alt\u0103 zon\u0103. C\u00e2nd cheagul se formeaz\u0103 \u00een vene, acesta este purtat de s\u00e2nge \u00een pl\u0103m\u00e2ni \u0219i vorbim de embolie pulmonar\u0103. Dac\u0103 se formeaz\u0103 \u00een inim\u0103, sau \u00eentr-o arter\u0103 mare \u0219i este transportat \u00een alt\u0103 arter\u0103 mai mic\u0103, se nume\u0219te embolie arterial\u0103. Prin embolie, artera mai mic\u0103 \u00een care se opre\u0219te cheagul se \u00eenfund\u0103, iar organul deservit sufer\u0103.<\/p>\n<p>De ce se formeaz\u0103 cheagurile?<\/p>\n<p>S\u00e2ngele are o sarcin\u0103 aparent imposibil\u0103: trebuie s\u0103 curg\u0103 continuu prin tot corpul \u00eentreaga via\u021b\u0103, dar s\u0103 se \u00eenchege rapid, pentru a preveni hemoragiile, atunci c\u00e2nd suferi\u021bi o v\u0103t\u0103mare.<\/p>\n<p>Exist\u0103 dou\u0103 condi\u021bii necesare pentru ca s\u00e2ngele s\u0103 NU se coaguleze \u00een sistemul circulator: pere\u021bii vaselor s\u0103 fie integrii, s\u0103 nu fie leza\u021bi \u00een niciun fel, iar cea dea doua &#8211; s\u00e2ngele trebuie s\u0103 curg\u0103 continuu. Dac\u0103 se produc leziuni ale pere\u021bilor vasculari, sau curgerea s\u00e2ngelui este oprit\u0103 printr-un vas, se formeaz\u0103 cheaguri.<\/p>\n<p>Fibrila\u021bia atrial\u0103 este o boal\u0103 a inimii \u00een care camerele superioare, atriile, se contract\u0103 haotic, foarte des \u0219i \u00een acest fel nu expulzeaz\u0103 complet s\u00e2ngele \u00een ventricoli, camerele inferioare. \u00cen aceste condi\u021bii, s\u00e2ngele r\u00e2m\u00e2ne \u00een aceste c\u0103m\u0103ru\u021be \u0219i se \u00eencheag\u0103 par\u021bial. Aceste cheaguri ajung \u00een cele din urm\u0103 \u00een restul circula\u021biei \u0219i produc embolia arterial\u0103.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-11 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"embolectomia arteriala\" title=\"embolectomia arteriala\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-400x304.jpg\" class=\"img-responsive wp-image-2673\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Cum se manifest\u0103 embolia?<\/p>\n<p>Manifest\u0103rile clinice sunt legate de organul afectat de embolie, \u00een care circula\u021bia a fost blocat\u0103:<\/p>\n<p>&#8211; cheagurile care ajung \u00een creier produc accident vascular ischemic, cu paralizie, tulbur\u0103ri de vedere \u0219i vorbire, imposibilitatea coordon\u0103ri mi\u0219c\u0103rilor;<\/p>\n<p>&#8211; cheagurile ajunse \u00een abdomen produc infarcte intestinale, cu dureri intense \u0219i necrozarea unei p\u0103r\u021bi din intestine;<\/p>\n<p>&#8211; cheagurile care blocheaz\u0103 circula\u021bia \u00een membre produc dureri \u0219i pierderea func\u021biei membrului respectiv.<\/p>\n<p>Cum se realizeaz\u0103 embolectomia?<\/p>\n<p>Pentru a restabili circula\u021bia, exist\u0103 dou\u0103 posibilit\u0103\u021bi: fie cheagul este extras chirurgical, fie este dizolvat prin administrarea unor medicamente speciale.<\/p>\n<p>\u00cen cazul interven\u021biei chirurgicale, chirurgul expune artera afectat\u0103 \u0219i introduce \u00een interiorul acesteia, dup\u0103 ce o deschide, un cateter special, cu ajutorul c\u0103ruia extrage cheagul respectiv. La finalul interven\u021biei, artera este suturat\u0103 \u0219i plaga operatorie \u00eenchis\u0103.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-12 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Interven\u021bie embolectomie arteriala\" title=\"embolectomia arteriala 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-400x304.jpg\" class=\"img-responsive wp-image-2672\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<p>Dup\u0103 extragerea cheagului, circula\u021bia este restabilit\u0103 \u0219i organul respectiv \u00ee\u0219i reia func\u021bia normal\u0103. Este important s\u0103 se intervin\u0103 \u00een timpul cel mai scurt, pentru a preveni leziuni ireversibile cauzate de lipsa circula\u021biei timp \u00eendelungat.<\/p>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-0910dbe2e91d2f2e0e3\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-accesulvascularpentruhemodializ\u0103\" href=\"#tab-0910dbe2e91d2f2e0e3\"><h4 class=\"fusion-tab-heading\">Accesul vascular pentru hemodializ\u0103<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-accesulvascularpentruhemodializ\u0103\" id=\"tab-0910dbe2e91d2f2e0e3\">\n<p><strong>Accesul vascular pentru hemodializ\u0103<\/strong><\/p>\n<p>Un pas important \u00eenainte de \u00eenceperea tratamentului de hemodializ\u0103 este efectuarea unei interven\u021bii chirurgicale minore pentru a crea un acces vascular. Hemodializa este un tratament pentru filtrarea de\u0219eurilor \u0219i a apei din s\u00e2nge, a\u0219a cum rinichii fac c\u00e2nd sunt s\u0103n\u0103to\u0219i. Hemodializa ajut\u0103 la controlul tensiunii arteriale \u0219i la echilibrarea mineralelor importante din s\u00e2nge, precum potasiu, sodiu \u0219i calciu.<\/p>\n<p>De ce este necesar crearea unui acces vascular?<\/p>\n<p>Accesul vascular este punctul de leg\u0103tur\u0103 dintre corp \u0219i aparatul de dializ\u0103, locul unde acele sunt inserate pentru a realiza circuitul. Aparatul de dializ\u0103 lucreaz\u0103 la un debit foarte ridicat. El extrage \u0219i returneaz\u0103 \u00een organism aproape jum\u0103tate de litru de s\u00e2nge \u00een fiecare minut.<\/p>\n<p>Exist\u0103 trei tipuri de acces vascular:<\/p>\n<p>&#8211; fistula arterio-venoas\u0103 (FAV)<\/p>\n<p>&#8211; grefonul sintetic arterio-venos<\/p>\n<p>&#8211; cateterul de hemodializ\u0103<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-13 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular pentru hemodializ\u0103\" title=\"accesul vascular pt hemodializa\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-400x304.jpg\" class=\"img-responsive wp-image-2674\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este fistula arterio-venoas\u0103?<\/p>\n<p>Cel mai bun tip de acces vascular pe termen lung este o fistul\u0103 arterio-venoas\u0103. Chirurgul conecteaz\u0103 o arter\u0103 la o ven\u0103, de obicei \u00een bra\u021b, pentru a crea o fistul\u0103 AV. O arter\u0103 este un vas de s\u00e2nge care transporta s\u00e2ngele oxigenat dinspre inim\u0103 spre restul corpului, iar o ven\u0103 este un vas de s\u00e2nge care readuce s\u00e2nge \u00eenapoi spre inim\u0103. Atunci c\u00e2nd chirurgul conecteaz\u0103 artera la o ven\u0103, vena respectiv\u0103 devine mai larg\u0103 \u0219i mai groas\u0103, f\u0103c\u00e2nd mai u\u0219or plasarea acelor pentru dializ\u0103. Fistula AV are, de asemenea, un diametru mare care permite s\u00e2ngelui s\u0103 curg\u0103 din corp \u00een aparatul de dializ\u0103 \u0219i \u00eenapoi \u00een corp rapid. Scopul este de a permite un flux sanguin ridicat, astfel \u00eenc\u00e2t cea mai mare cantitate de s\u00e2nge s\u0103 treac\u0103 prin dializor.<\/p>\n<p>Fistula AV este considerat\u0103 cea mai bun\u0103 op\u021biune deoarece aceasta:<\/p>\n<p>&#8211; asigur\u0103 fluxul cel mai ridicat de s\u00e2nge pentru dializ\u0103;<\/p>\n<p>&#8211; are un risc mai mic s\u0103 se infecteze sau s\u0103 se blocheze;<\/p>\n<p>&#8211; are o durat\u0103 de via\u021b\u0103 mai lung\u0103.<\/p>\n<p>Majoritatea pacien\u021bilor pot merge acas\u0103 imediat dup\u0103 interven\u021bie, \u00een aceea\u0219i zi. Opera\u021bia se realizeaz\u0103 de obicei \u00een anestezie local\u0103, fiind amor\u021bit\u0103 doar zona \u00een care chirurgul creeaz\u0103 fistula AV, dar, \u00een func\u021bie de situa\u021bia pacientului, se poate opta pentru anestezie general\u0103.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-14 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular\" title=\"hemodializa 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/hemodializa-2-400x304.jpg\" class=\"img-responsive wp-image-2675\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este grefonul arterio-venos?<\/p>\n<p>Dac\u0103 venele nu permit realizarea unei fistule AV, se poate opta pentru implantarea unui grefon AV. \u00cen acest caz, chirurgul utilizeaz\u0103 un tub artificial pentru a conecta o arter\u0103 la o ven\u0103. Un grefon AV pentru dializ\u0103 poate fi utilizat la scurt timp dup\u0103 interven\u021bia chirurgical\u0103.<\/p>\n<p>Cu toate acestea, exist\u0103 un risc mai ridicat de infec\u021bie \u0219i de formare a cheagurilor de s\u00e2nge \u00een grefon. Cheagurile pot bloca fluxul de s\u00e2nge prin grefon \u0219i pot face dificil\u0103 sau imposibil\u0103 dializa.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-15 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular hemodializ\u0103\" title=\"hemodializa\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/hemodializa-400x304.jpg\" class=\"img-responsive wp-image-2677\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este cateterul de hemodializ\u0103?<\/p>\n<p>Dac\u0103 boala de rinichi progreseaz\u0103 rapid \u0219i nu este timp pentru efectuarea unei proceduri de acces vascular \u00eenainte de dializ\u0103, este necesar\u0103 implantarea unui cateter venos &#8211; un tub mic \u0219i moale inserat \u00eentr-o ven\u0103 \u00een g\u00e2t, piept sau picior, ca acces temporar.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-16 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular hemodializ\u0103\" title=\"hemodializa 3\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/hemodializa-3-400x304.jpg\" class=\"img-responsive wp-image-2676\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div><\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-9d97b21c75c01295578\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-accesulvascularpentruchimioterapie\" href=\"#tab-9d97b21c75c01295578\"><h4 class=\"fusion-tab-heading\">Accesul vascular pentru chimioterapie<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-accesulvascularpentruchimioterapie\" id=\"tab-9d97b21c75c01295578\">\n<p><strong>Accesul vascular pentru chimioterapie<\/strong><\/p>\n<p><strong>\u00a0<\/strong>O camer\u0103-port este un dispozitiv mic de acces venos, aproximativ de m\u0103rimea unei monede, folosit pentru a administra medicamente \u00een s\u00e2nge. Este implantat\u0103 sub piele, de obicei \u00een partea superioar\u0103 a pieptului. Porturile sunt utilizate la pacien\u021bii care necesit\u0103 administrarea frecvent\u0103 de chimioterapie, transfuzii de s\u00e2nge, antibiotice, hr\u0103nire intravenoas\u0103 sau recolt\u0103ri de s\u00e2nge frecvente pentru analize. Dispozitivul este format din corpul portului \u0219i un cateter. Corpul portului are una sau mai multe camere distincte care sunt sigilate cu un capac moale (sept), siliconic, care poate fi str\u0103puns cu ace speciale. Un cateter moale, din plastic, se conecteaz\u0103 la corpul portului \u0219i v\u00e2rful cateterului este plasat \u00eentr-una din vene centrale mari din piept, care transporta s\u00e2nge \u00een inim\u0103.<\/p>\n<p>Care sunt avantajele unei camere-port?<\/p>\n<p>Un port are urm\u0103toarele avantaje:<\/p>\n<p>&#8211; r\u0103m\u00e2ne implantat luni sau ani, \u00een func\u021bie de c\u00e2t timp este necesar;<\/p>\n<p>&#8211; reduce num\u0103rul de \u00een\u021bep\u0103turi \u00een vene pentru a recolta s\u00e2nge sau a infuza medicamente sau lichide;<\/p>\n<p>&#8211; reduce durerea \u0219i timpul petrecut \u00een \u00eencercarea de a accesa o ven\u0103 adecvat\u0103;<\/p>\n<p>&#8211; medicamentele administrate sunt diluate de s\u00e2nge, lez\u00e2nd mai pu\u021bin peretele venos;<\/p>\n<p>&#8211; mai multe tipuri de medicamente sau alte tratamente pot fi administrate \u00een acela\u0219i timp cu ajutorul unui port cu dou\u0103 camere.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-17 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Chirurgie vascular\u0103 Timi\u0219oara\" title=\"chimioterapie\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/chimioterapie-400x304.jpg\" class=\"img-responsive wp-image-2679\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Cum se realizeaz\u0103 interven\u021bia de implantare?<\/p>\n<p>Opera\u021bia de implantare a camerei-port este o procedur\u0103 scurt\u0103, efectuat\u0103 sub anestezie local\u0103 \u0219i \u00een condi\u021bii sterile. Zona \u00een care va fi inserat portul este sterilizat\u0103, apoi amor\u021bit\u0103 cu un anestezic local. \u00cen timpul procedurii, chirurgul face o\u00a0 incizie de 4-5 cm la baza um\u0103rului. Pe aceast\u0103 incizie identific\u0103 vena subclavie, \u00een care introduce cateterul. Apoi chirurgul face un buzunar sub piele, \u00een care corpul portului va fi plasat \u0219i securizat, apoi conectat la cateter. Incizia va fi \u00eenchis\u0103 cu suturi resorbabile.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-18 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular\" title=\"chimioterapia 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/chimioterapia-2-400x304.jpg\" class=\"img-responsive wp-image-2678\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<\/div><\/div><\/div><\/div><style type=\"text\/css\">.fusion-body 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top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:30px;width:100%;\"><\/div><div ><style>.fusion-button.button-1{border-radius:4px 4px 4px 4px;}<\/style><a class=\"fusion-button button-flat fusion-button-default-size button-default button-1 fusion-button-default-span fusion-button-default-type\" target=\"_self\" href=\"tel:+40721936835\"><span class=\"fusion-button-text\">PROGRAMEAZ\u0102-TE ACUM PENTRU O CONSULTA\u021aIE<\/span><\/a><\/div><div ><style>.fusion-imageframe.imageframe-19{ margin-top : 50px;}<\/style><span class=\" fusion-imageframe imageframe-none imageframe-19 hover-type-none\"><img width=\"2048\" height=\"1365\" title=\"AZ3I6222\" src=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/02\/AZ3I6222.jpg\" alt class=\"img-responsive wp-image-5303\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2023\/02\/AZ3I6222-200x133.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/02\/AZ3I6222-400x267.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/02\/AZ3I6222-600x400.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/02\/AZ3I6222-800x533.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/02\/AZ3I6222-1200x800.jpg 1200w, https:\/\/medcom.ro\/wp-content\/uploads\/2023\/02\/AZ3I6222.jpg 2048w\" sizes=\"(max-width: 640px) 100vw, 2048px\" \/><\/span><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-2{width:100% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-2 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 0px;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 0px;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-2{width:100% !important;}.fusion-builder-column-2 > .fusion-column-wrapper {margin-right : 0px;margin-left : 0px;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-2{width:100% !important;}.fusion-builder-column-2 > .fusion-column-wrapper {margin-right : 0px;margin-left : 0px;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-2{ padding-top : 0%;margin-top : 0px;padding-right : 5%;padding-bottom : 0%;margin-bottom : 0px;padding-left : 5%;}<\/style><\/div><\/div><div id=\"chirurgievasculara\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-no-large-visibility\" style=\"background-color: rgba(255,255,255,0);background-position: center top;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#e2e2e2;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:calc( 1200px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-tabs fusion-tabs-2 clean vertical-tabs icon-position-left\"><style type=\"text\/css\">#wrapper .fusion-tabs.fusion-tabs-2.clean .nav-tabs li a.tab-link{border-color:#d5a748;}.fusion-tabs.fusion-tabs-2 .nav-tabs li a.tab-link{background-color:#d5a748;}.fusion-tabs.fusion-tabs-2 .nav-tabs li.active a.tab-link,.fusion-tabs.fusion-tabs-2 .nav-tabs li.active a.tab-link:hover,.fusion-tabs.fusion-tabs-2 .nav-tabs li.active a.tab-link:focus{background-color:#ffffff;}.fusion-tabs.fusion-tabs-2 .nav-tabs li a:hover{background-color:#ffffff;border-top-color:#ffffff;}.fusion-tabs.fusion-tabs-2 .tab-pane{background-color:#ffffff;}.fusion-tabs.fusion-tabs-2 .nav,.fusion-tabs.fusion-tabs-2 .nav-tabs,.fusion-tabs.fusion-tabs-2 .tab-content .tab-pane{border-color:#d5a748;}<\/style><div class=\"nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li class=\"active\" role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-b21bc2a135f3809a943\" aria-selected=\"true\" id=\"fusion-tab-tratamentulvaricelorprinmetodac.h.i.v.a\" href=\"#tab-b21bc2a135f3809a943\"><h4 class=\"fusion-tab-heading\">Tratamentul varicelor prin metoda C.H.I.V.A<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-6d03ec831c404354555\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-flebectomiilepentruvarice\" href=\"#tab-6d03ec831c404354555\"><h4 class=\"fusion-tab-heading\">Flebectomiile pentru varice<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-b5896b5cb3ded469ffc\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-bypassularterial\" href=\"#tab-b5896b5cb3ded469ffc\"><h4 class=\"fusion-tab-heading\">Bypassul arterial<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-79640c787b11a66cc53\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-endarterectomiacarotidian\u0103\" href=\"#tab-79640c787b11a66cc53\"><h4 class=\"fusion-tab-heading\">Endarterectomia Carotidian\u0103<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-751bed3635a6716ab58\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-endarterectomiafemural\u0103\" href=\"#tab-751bed3635a6716ab58\"><h4 class=\"fusion-tab-heading\">Endarterectomia femural\u0103<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-47f9e892969a631cfb5\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-embolectomiaarterial\u0103\" href=\"#tab-47f9e892969a631cfb5\"><h4 class=\"fusion-tab-heading\">Embolectomia arterial\u0103<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-1751891c287bdcf9c07\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-accesulvascularpentruhemodializ\u0103\" href=\"#tab-1751891c287bdcf9c07\"><h4 class=\"fusion-tab-heading\">Accesul vascular pentru hemodializ\u0103<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-eae55148d86c9d9871f\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-accesulvascularpentruchimioterapie\" href=\"#tab-eae55148d86c9d9871f\"><h4 class=\"fusion-tab-heading\">Accesul vascular pentru chimioterapie<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-content\"><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li class=\"active\" role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-b21bc2a135f3809a943\" aria-selected=\"true\" id=\"mobile-fusion-tab-tratamentulvaricelorprinmetodac.h.i.v.a\" href=\"#tab-b21bc2a135f3809a943\"><h4 class=\"fusion-tab-heading\">Tratamentul varicelor prin metoda C.H.I.V.A<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix in active\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-tratamentulvaricelorprinmetodac.h.i.v.a\" id=\"tab-b21bc2a135f3809a943\">\n<p><strong>Chirurgia varicelor membrelor inferioare\u00a0<\/strong><\/p>\n<p>Ave\u021bi picioarele afectate de varice? Tratamentul v\u0103 este la \u00eendem\u00e2n\u0103! \u00cen clinica CBS Medcom, Dr. George P\u0103tru\u021b utilizeaz\u0103 tehnica CHIVA, o procedur\u0103 minim invaziv\u0103, folosit\u0103 uzual \u00een Fran\u021ba, pentru a v\u0103 elimina \u00een siguran\u021b\u0103 aceste dilata\u021bii venoase inestetice.<\/p>\n<p>De ce apar varicele?<\/p>\n<p>Varicele afecteaz\u0103 cel pu\u021bin unul din zece adul\u021bi. Cauza lor exact\u0103 este necunoscut\u0103, consider\u00e2ndu-se c\u0103 reprezint\u0103 o boal\u0103 a peretelui venos mo\u0219tenit\u0103. Exist\u0103 \u0219i factori agravan\u021bi: statul prelungit \u00een picioare, excesul de greutate, stilul de via\u021b\u0103 sedentar, c\u0103ldura, sarcina. Aceast\u0103 modificare progresiv\u0103 a peretelui venos este ireversibil\u0103 \u0219i determin\u0103 un reflux venos de sus \u00een jos, accentu\u00e2nd \u00een timp dilat\u0103rile varicoase.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-20 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Chirurgie vascular\u0103 Timi\u0219oara\" title=\"varice\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/varice-400x304.jpg\" class=\"img-responsive wp-image-2600\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este tehnica CHIVA?<\/p>\n<p>CHIVA reprezint\u0103 acronimul numelui procedurii &#8211; Cura Hemodinamic\u0103 a Insuficien\u021bei Venoase \u00een Ambulator. Principiul de baz\u0103 al interven\u021biei este ligaturarea venelor incontinente \u0219i \u00eendep\u0103rtarea pachetelor varicoase (flebectomii). Astfel se elimin\u0103 factorul cauzator al bolii varicoase \u0219i anume presiunea crescut\u0103 din sistemul venos superficial. Interven\u021bia este minim invaziv\u0103, inciziile sunt discrete \u0219i are acelea\u0219i efecte ca opera\u021bia clasic\u0103, \u00een care vena este smuls\u0103 din membrul inferior. Beneficiile sunt majore: durere minim\u0103 dup\u0103 opera\u021bie, lipsa s\u00e2nger\u0103rilor, risc foarte mic de infec\u021bie, reluarea imediat\u0103 a activit\u0103\u021bilor obi\u0219nuite<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-21 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Opera\u021bie varice\" title=\"varice 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/varice-2-400x304.jpg\" class=\"img-responsive wp-image-2599\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<ul>\n<li>Rezultatele finale pot fi apreciate la 3 s\u0103pt\u0103m\u00e2ni dup\u0103 interven\u021bie;<\/li>\n<li>Principalul beneficiu &#8211; dispari\u021bia dilata\u021biilor varicoase, cu efect de durat\u0103;<\/li>\n<li>Ameliorarea semnificativ\u0103 a simptomelor produse de varice: umflarea picioarelor, senza\u021bia de tensiune \u00een gambe, amor\u021beli;<\/li>\n<li>Men\u021binerea pe termen lung a rezultatelor depinde \u0219i de adoptarea unui stil de via\u021b\u0103 activ, purtarea ciorapilor elastici \u0219i p\u0103strarea greut\u0103\u021bii corporale \u00een limite normale.<\/li>\n<\/ul>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-6d03ec831c404354555\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-flebectomiilepentruvarice\" href=\"#tab-6d03ec831c404354555\"><h4 class=\"fusion-tab-heading\">Flebectomiile pentru varice<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-flebectomiilepentruvarice\" id=\"tab-6d03ec831c404354555\">\n<p><strong>Flebectomiile pentru varice<\/strong><\/p>\n<p><strong>\u00a0<\/strong>\u00cen cazul \u00een care boala venoas\u0103 cronic\u0103 nu este extrem de avansat\u0103 \u0219i sunt prezente doar c\u00e2teva dilata\u021bii varicoase, acestea pot fi operate prin flebectomii.<\/p>\n<p>De ce apar varicele?<\/p>\n<p>Varicele afecteaz\u0103 cel pu\u021bin unul din zece adul\u021bi. Cauza lor exact\u0103 este necunoscut\u0103, consider\u00e2ndu-se c\u0103 reprezint\u0103 o boal\u0103 a peretelui venos mo\u0219tenit\u0103. Exist\u0103 \u0219i factori agravan\u021bi: statul prelungit \u00een picioare, excesul de greutate, stilul de via\u021b\u0103 sedentar, c\u0103ldura, sarcina. Aceast\u0103 modificare progresiv\u0103 a peretelui venos este ireversibil\u0103 \u0219i determin\u0103 un reflux venos de sus \u00een jos, accentu\u00e2nd \u00een timp dilat\u0103rile varicoase.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-22 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Chirurgie vascular\u0103 Timi\u0219oara\" title=\"varice\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/varice-400x304.jpg\" class=\"img-responsive wp-image-2600\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/varice.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce sunt flebectomiile?<\/p>\n<p>Pentru a trata dilata\u021biile varicoase, chirurgul \u00een\u021beap\u0103 pielea cu v\u00eerful bisturiului \u0219i, prin aceast\u0103 mini incizie, aga\u021b\u0103 vena dilatat\u0103 cu un instrument special, apoi o extrage. La final, inciziile nu sunt suturate cu fire, ci cu c\u00e2teva benzi elastice adezive, care apropie \u0219i \u021bin lipite marginile pielii.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-23 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Flebectomie\" title=\"flebectomie\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/flebectomie-400x304.jpg\" class=\"img-responsive wp-image-2666\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/flebectomie.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<ul>\n<li>Rezultatele finale pot fi apreciate la 3 s\u0103pt\u0103m\u00e2ni dup\u0103 interven\u021bie;<\/li>\n<li>Principalul beneficiu &#8211; dispari\u021bia dilata\u021biilor varicoase, cu efect de durat\u0103;<\/li>\n<li>Ameliorarea semnificativ\u0103 a simptomelor produse de varice: umflarea picioarelor, senza\u021bia de tensiune \u00een gambe, amor\u021beli;<\/li>\n<li>Men\u021binerea pe termen lung a rezultatelor depinde \u0219i de adoptarea unui stil de via\u021b\u0103 activ, purtarea ciorapilor elastici \u0219i p\u0103strarea greut\u0103\u021bii corporale \u00een limite normale.<\/li>\n<\/ul>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-b5896b5cb3ded469ffc\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-bypassularterial\" href=\"#tab-b5896b5cb3ded469ffc\"><h4 class=\"fusion-tab-heading\">Bypassul arterial<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-bypassularterial\" id=\"tab-b5896b5cb3ded469ffc\">\n<p><strong>Bypass-ul arterial<\/strong><\/p>\n<p>Boala arterelor membrelor inferioare reprezint\u0103 \u00eengustarea, sau chiar blocarea total\u0103 a acestora. Astfel s\u00e2ngele nu mai ajunge \u00eentr-o cantitate suficient\u0103 \u00een zonele de sub blocaj.<\/p>\n<p>Este o boal\u0103 cronic\u0103, care se agraveaz\u0103 odat\u0103 cu trecerea timpului, produc\u00e2nd simptome din ce \u00een ce mai intense &#8211; ini\u021bial durere la mers, apoi durere \u0219i la repaus \u0219i, \u00een final, leziuni trofice ale pielii &#8211; necroze \u0219i gangrene.<\/p>\n<p>De ce se \u00eemboln\u0103vesc arterele?<\/p>\n<p>Aceast\u0103 boal\u0103 este cauzat\u0103 de formarea de pl\u0103ci de aterom \u00een arterele care duc s\u00e2nge \u00een picior. Pl\u0103cile de aterom sunt aglomer\u0103ri de colesterol, calciu, \u021besut fibros \u0219i alte resturi celulare care se acumuleaz\u0103 \u00een pere\u021bii arterei. Procesul se nume\u0219te ateroscleroz\u0103. Pl\u0103cile ateromatoase se dezvolt\u0103 \u00een principal din cauza turbulen\u021belor fluxului sanguin, ap\u0103rute mai ales la bifurca\u021biile arteriale \u0219i sunt agravate de factorii de risc cardiovascular: tutun, hipertensiune arterial\u0103, anomalii lipidice (excesul de colesterol), diabet \u0219i \u00eemb\u0103tr\u00e2nire.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-24 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Bypass arterial\" title=\"bypassul arterial\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/bypassul-arterial-400x304.jpg\" class=\"img-responsive wp-image-2669\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Cum se manifest\u0103 boala arterial\u0103 periferic\u0103?<\/p>\n<p>Manifest\u0103rile clinice sunt legate de gradul de \u00eengustare a arterei \u0219i sunt clasificate \u00een trei stadii de cre\u0219tere a severit\u0103\u021bii:<\/p>\n<ol>\n<li>Durerile de efort: sunt dureri asem\u0103n\u0103toare cu crampele musculare sau se pot manifesta ca o senza\u021bie de oboseal\u0103 a anumitor grupe musculare (coapse, gambe). Aceste dureri sunt declan\u0219ate de efort \u0219i dispar dup\u0103 repaus. Ele apar \u00een timpul mersului pe jos, niciodat\u0103 \u00een repaus sau la simplul stat \u00een picioare. Distan\u021ba parcurs\u0103 \u00eenainte de apari\u021bia durerii (perimetrul de mers pe jos) poate varia de la c\u00e2\u021biva metri la mai mult de 500 de metri \u0219i este un bun indicator al severit\u0103\u021bii bolii.<\/li>\n<li>Durerile de repaus: sunt mai ales nocturne, intense, adesea intolerabile, localizate la nivelul degetelor sau piciorului. Aceste dureri sunt asociate cu extremit\u0103\u021bi reci. \u00cei for\u021beaz\u0103 pe pacient s\u0103 se ridice sau s\u0103-\u0219i at\u00e2rne picioarele la marginea patului, apoi cedeaz\u0103 treptat. Aceste dureri reflect\u0103 un grad avansat al bolii \u0219i necesit\u0103 consiliere medical\u0103 urgent\u0103 \u00eenainte de apari\u021bia leziunilor ulcerative sau a gangrenei.<\/li>\n<li>Apari\u021bia pl\u0103gilor sau a gangrenei (ultimul stadiu de evolu\u021bie) poate antrena pierderea membrului inferior.<\/li>\n<\/ol>\n<p>Ce este bypass-ul arterial?<\/p>\n<p>Opera\u021bia const\u0103 \u00een ocolirea segmentului bolnav al arterei. \u00cen acest scop, chirurgul recolteaz\u0103 vena safen\u0103 mare, care este vena cea mai lung\u0103 a piciorului \u0219i o conecteaz\u0103 la arter\u0103 deasupra \u0219i sub zona bolnav\u0103. Astfel, s\u00e2ngele este deviat prin ven\u0103 \u0219i ocole\u0219te segmentul arterial bolnav. \u00cen cazul \u00een care vena pacientului este prea sub\u021bire \u0219i nu poate fi folosit\u0103, se utilizeaz\u0103 o protez\u0103 din material sintetic.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-25 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Bypass arterial\" title=\"bypassul arterial 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-400x304.jpg\" class=\"img-responsive wp-image-2668\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<p>Rezultatele pe termen lung ale acestei opera\u021bii sunt excelente. Un bypass cu ven\u0103 poate r\u0103m\u00e2ne func\u021bional mai mult de 20 de ani, dac\u0103 factorii de risc ai aterosclerozei sunt bine controla\u021bi &#8211; renun\u021bare la fumat, controlul tensiunii arteriale, al diabetului \u0219i colesterolului.<\/p>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-79640c787b11a66cc53\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-endarterectomiacarotidian\u0103\" href=\"#tab-79640c787b11a66cc53\"><h4 class=\"fusion-tab-heading\">Endarterectomia Carotidian\u0103<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-endarterectomiacarotidian\u0103\" id=\"tab-79640c787b11a66cc53\">\n<p><strong>Endarterectomia carotidian\u0103<\/strong><\/p>\n<p>\u00cengustarea \u0219i calcificarea arterelor carotide\u00a0 reprezint\u0103 o boal\u0103 extrem de serioas\u0103, care poate avea consecin\u021be majore, cea mai periculoas\u0103 fiind accidentul vascular cerebral. Acesta este o urgen\u021b\u0103 medical\u0103 imediat\u0103, alimentarea cu s\u00e2nge a creierului fiind \u00eentrerupt\u0103 sau redus\u0103 brusc.<\/p>\n<p>Cum apare boala carotidian\u0103?<\/p>\n<p>Boala arterei carotide este cauzat\u0103 de acumularea de pl\u0103ci de aterom \u00een arterele care duc s\u00e2nge \u00een creier. Pl\u0103cile de aterom sunt aglomer\u0103ri de colesterol, calciu, \u021besut fibros \u0219i alte resturi celulare care se acumuleaz\u0103 \u00een pere\u021bii arterei. Acest proces se nume\u0219te ateroscleroz\u0103. Arterele carotide care sunt afectate de ateroscleroz\u0103 devin rigide \u0219i \u00eengustate \u0219i au dificult\u0103\u021bi \u00een a furniza oxigen \u0219i substan\u021be nutritive structurilor vitale din creier care sunt responsabile pentru func\u021bionarea zilnic\u0103 a organismului.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-26 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"endarterectomie\" title=\"endarterectomie\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/endarterectomie-400x304.jpg\" class=\"img-responsive wp-image-2613\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este endarterectomia carotidian\u0103?<\/p>\n<p>Scopul tratamentului bolii arterei carotide este de a preveni accidentul vascular cerebral. Acesta se produce atunci c\u00e2nd buc\u0103\u021bi din pl\u0103cile de aterom din artera bolnav\u0103 se desprind \u0219i sunt purtate de s\u00e2nge \u00een creier, unde \u00eenfund\u0103 vasele locale, astfel c\u0103 acea por\u021biune din creier nu mai prime\u0219te s\u00e2nge \u0219i oxigen. Pentru a extrage aceste pl\u0103ci de aterom, chirurgul face o incizie de 10-15 cm pe partea lateral\u0103 a g\u00e2tului, disec\u0103 artera de structurile \u00eenconjur\u0103toare, o deschide \u0219i o cur\u0103\u021b\u0103, apoi coase un petec din material sintetic pentru a o l\u0103rgi. Opera\u021bia se realizeaz\u0103 \u00een anestezie local\u0103 \u0219i necesit\u0103 o perioad\u0103 de spitalizare de 3-4 zile.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-27 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"endarterectomie carotidiana\" title=\"endarterectomie carotidiana\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-400x304.jpg\" class=\"img-responsive wp-image-2612\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/endarterectomie-carotidiana.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<p>Rezultatele endarterectomiei carotidiene sunt, \u00een general, foarte satisf\u0103c\u0103toare. Cu toate acestea exist\u0103 un risc de re-\u00eengustare comun tuturor interven\u021biilor asupra sistemului arterial, legat de o &#8222;cicatrizare&#8221; rea a arterei. Acest fenomen poate ap\u0103rea \u00een cursul primului an, mecanismul \u0219i prevenirea acestuia nefiind momentan cunoscute.<\/p>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-751bed3635a6716ab58\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-endarterectomiafemural\u0103\" href=\"#tab-751bed3635a6716ab58\"><h4 class=\"fusion-tab-heading\">Endarterectomia femural\u0103<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-endarterectomiafemural\u0103\" id=\"tab-751bed3635a6716ab58\">\n<p><strong>Endarterectomia femural\u0103<\/strong><\/p>\n<p><strong>\u00a0<\/strong>\u201cButuruga mic\u0103 r\u0103stoarn\u0103 carul mare\u201d, un proverb vechi care se aplic\u0103 perfect \u00een cazul bolii arterelor femurale. Artera femural\u0103 comun\u0103 este o arter\u0103 scurt\u0103, de 4-5 cm, situat\u0103 la baza piciorului, care se \u00eemparte \u00een dou\u0103 ramuri. Prima, artera femurala profund\u0103, transport\u0103 s\u00e2ngele c\u0103tre mu\u0219chii coapsei, iar cea de-a doua, artera femural\u0103 superficial\u0103, coboar\u0103 p\u00e2n\u0103 sub genunchi, unde deserve\u0219te mu\u0219chii gambei. Astfel c\u0103, \u00eemboln\u0103virea acestei artere are repercursiuni asupra circula\u021biei \u00eentregului membru inferior.<\/p>\n<p>De ce se \u00eemboln\u0103vesc arterele?<\/p>\n<p>Boala arterelor reprezint\u0103, de fapt, formarea de pl\u0103ci de aterom \u00een pere\u021bii acestora. Pl\u0103cile de aterom sunt aglomer\u0103ri de colesterol, calciu, \u021besut fibros \u0219i alte resturi celulare care se acumuleaz\u0103 \u00een timp \u0219i \u00eengusteaz\u0103 vasul. Procesul se nume\u0219te ateroscleroz\u0103. Pl\u0103cile ateromatoase se dezvolt\u0103 \u00een principal din cauza turbulen\u021belor fluxului sanguin, ap\u0103rute mai ales la bifurca\u021biile arteriale \u0219i sunt agravate de factorii de risc cardiovascular: tutun, hipertensiune arterial\u0103, anomalii lipidice (excesul de colesterol), diabet \u0219i \u00eemb\u0103tr\u00e2nire.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-28 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Bypass arterial\" title=\"bypassul arterial\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/bypassul-arterial-400x304.jpg\" class=\"img-responsive wp-image-2669\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/bypassul-arterial.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Cum se manifest\u0103 boala arterial\u0103 periferic\u0103?<\/p>\n<p>Manifest\u0103rile clinice sunt legate de gradul de \u00eengustare a arterei \u0219i sunt clasificate \u00een trei stadii de cre\u0219tere a severit\u0103\u021bii:<\/p>\n<ol>\n<li>Durerile de efort: sunt dureri asem\u0103n\u0103toare cu crampele musculare sau se pot manifesta ca o senza\u021bie de oboseal\u0103 a anumitor grupe musculare (coapse, gambe). Aceste dureri sunt declan\u0219ate de efort \u0219i dispar dup\u0103 repaus. Ele apar \u00een timpul mersului pe jos, niciodat\u0103 \u00een repaus sau la simplul stat \u00een picioare. Distan\u021ba parcurs\u0103 \u00eenainte de apari\u021bia durerii (perimetrul de mers pe jos) poate varia de la c\u00e2\u021biva metri la mai mult de 500 de metri \u0219i este un bun indicator al severit\u0103\u021bii bolii.<\/li>\n<li>Durerile de repaus: sunt mai ales nocturne, intense, adesea intolerabile, localizate la nivelul degetelor sau piciorului. Aceste dureri sunt asociate cu extremit\u0103\u021bi reci. \u00cei for\u021beaz\u0103 pe pacient s\u0103 se ridice sau s\u0103-\u0219i at\u00e2rne picioarele la marginea patului, apoi cedeaz\u0103 treptat. Aceste dureri reflect\u0103 un grad avansat al bolii \u0219i necesit\u0103 consiliere medical\u0103 urgent\u0103 \u00eenainte de apari\u021bia leziunilor ulcerative sau a gangrenei.<\/li>\n<li>Apari\u021bia pl\u0103gilor sau a gangrenei (ultimul stadiu de evolu\u021bie) poate antrena pierderea membrului inferior.<\/li>\n<\/ol>\n<p>Ce este endarterectomia femural\u0103?<\/p>\n<p>Opera\u021bia se realizeaz\u0103, de obicei, \u00een anestezie local\u0103. Scopul interven\u021biei este restabilirea circula\u021biei prin \u00eendep\u0103rtarea pl\u0103cilor de aterom. Printr-o incizie de 5-6 cm, chirurgul deschide artera \u0219i extrage cu un instrument special toate pl\u0103cile ateromatoase. La final, artera este l\u0103rgit\u0103 prin suturarea unui petec croit dintr-o ven\u0103 recoltat\u0103 de deasupra gleznei.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-29 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Chirurgie vascular\u0103 Timi\u0219oara\" title=\"femurala\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/femurala-400x304.jpg\" class=\"img-responsive wp-image-2671\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/femurala.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<p>Pentru c\u0103 artera femural\u0103 se g\u0103se\u0219te aproape de piele \u0219i incizia este scurt\u0103, recuperarea este rapid\u0103, cu un disconfort dureros mic, doar \u00een primele dou\u0103 zile. Dac\u0103 pacientul ader\u0103 la stilul de via\u021b\u0103 recomandat de medic, cu un control strict al factorilor de risc &#8211; renun\u021barea la fumat, controlul tensiunii arteriale, al diabetului \u0219i colesterolului &#8211; efectele benefice produse de interven\u021bie se vor manifesta pe perioad\u0103 \u00eendelungat\u0103, de zeci de ani.<\/p>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-47f9e892969a631cfb5\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-embolectomiaarterial\u0103\" href=\"#tab-47f9e892969a631cfb5\"><h4 class=\"fusion-tab-heading\">Embolectomia arterial\u0103<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-embolectomiaarterial\u0103\" id=\"tab-47f9e892969a631cfb5\">\n<p><strong>Embolectomia arterial\u0103<\/strong><\/p>\n<p>Un embol este un cheag de s\u00e2nge care s-a format \u00eentr-o zon\u0103 a organismului \u0219i a fost purtat de s\u00e2nge \u00een alt\u0103 zon\u0103. C\u00e2nd cheagul se formeaz\u0103 \u00een vene, acesta este purtat de s\u00e2nge \u00een pl\u0103m\u00e2ni \u0219i vorbim de embolie pulmonar\u0103. Dac\u0103 se formeaz\u0103 \u00een inim\u0103, sau \u00eentr-o arter\u0103 mare \u0219i este transportat \u00een alt\u0103 arter\u0103 mai mic\u0103, se nume\u0219te embolie arterial\u0103. Prin embolie, artera mai mic\u0103 \u00een care se opre\u0219te cheagul se \u00eenfund\u0103, iar organul deservit sufer\u0103.<\/p>\n<p>De ce se formeaz\u0103 cheagurile?<\/p>\n<p>S\u00e2ngele are o sarcin\u0103 aparent imposibil\u0103: trebuie s\u0103 curg\u0103 continuu prin tot corpul \u00eentreaga via\u021b\u0103, dar s\u0103 se \u00eenchege rapid, pentru a preveni hemoragiile, atunci c\u00e2nd suferi\u021bi o v\u0103t\u0103mare.<\/p>\n<p>Exist\u0103 dou\u0103 condi\u021bii necesare pentru ca s\u00e2ngele s\u0103 NU se coaguleze \u00een sistemul circulator: pere\u021bii vaselor s\u0103 fie integrii, s\u0103 nu fie leza\u021bi \u00een niciun fel, iar cea dea doua &#8211; s\u00e2ngele trebuie s\u0103 curg\u0103 continuu. Dac\u0103 se produc leziuni ale pere\u021bilor vasculari, sau curgerea s\u00e2ngelui este oprit\u0103 printr-un vas, se formeaz\u0103 cheaguri.<\/p>\n<p>Fibrila\u021bia atrial\u0103 este o boal\u0103 a inimii \u00een care camerele superioare, atriile, se contract\u0103 haotic, foarte des \u0219i \u00een acest fel nu expulzeaz\u0103 complet s\u00e2ngele \u00een ventricoli, camerele inferioare. \u00cen aceste condi\u021bii, s\u00e2ngele r\u00e2m\u00e2ne \u00een aceste c\u0103m\u0103ru\u021be \u0219i se \u00eencheag\u0103 par\u021bial. Aceste cheaguri ajung \u00een cele din urm\u0103 \u00een restul circula\u021biei \u0219i produc embolia arterial\u0103.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-30 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"embolectomia arteriala\" title=\"embolectomia arteriala\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-400x304.jpg\" class=\"img-responsive wp-image-2673\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Cum se manifest\u0103 embolia?<\/p>\n<p>Manifest\u0103rile clinice sunt legate de organul afectat de embolie, \u00een care circula\u021bia a fost blocat\u0103:<\/p>\n<p>&#8211; cheagurile care ajung \u00een creier produc accident vascular ischemic, cu paralizie, tulbur\u0103ri de vedere \u0219i vorbire, imposibilitatea coordon\u0103ri mi\u0219c\u0103rilor;<\/p>\n<p>&#8211; cheagurile ajunse \u00een abdomen produc infarcte intestinale, cu dureri intense \u0219i necrozarea unei p\u0103r\u021bi din intestine;<\/p>\n<p>&#8211; cheagurile care blocheaz\u0103 circula\u021bia \u00een membre produc dureri \u0219i pierderea func\u021biei membrului respectiv.<\/p>\n<p>Cum se realizeaz\u0103 embolectomia?<\/p>\n<p>Pentru a restabili circula\u021bia, exist\u0103 dou\u0103 posibilit\u0103\u021bi: fie cheagul este extras chirurgical, fie este dizolvat prin administrarea unor medicamente speciale.<\/p>\n<p>\u00cen cazul interven\u021biei chirurgicale, chirurgul expune artera afectat\u0103 \u0219i introduce \u00een interiorul acesteia, dup\u0103 ce o deschide, un cateter special, cu ajutorul c\u0103ruia extrage cheagul respectiv. La finalul interven\u021biei, artera este suturat\u0103 \u0219i plaga operatorie \u00eenchis\u0103.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-31 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Interven\u021bie embolectomie arteriala\" title=\"embolectomia arteriala 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-400x304.jpg\" class=\"img-responsive wp-image-2672\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/embolectomia-arteriala-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Rezultatele interven\u021biei:<\/p>\n<p>Dup\u0103 extragerea cheagului, circula\u021bia este restabilit\u0103 \u0219i organul respectiv \u00ee\u0219i reia func\u021bia normal\u0103. Este important s\u0103 se intervin\u0103 \u00een timpul cel mai scurt, pentru a preveni leziuni ireversibile cauzate de lipsa circula\u021biei timp \u00eendelungat.<\/p>\n<\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-1751891c287bdcf9c07\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-accesulvascularpentruhemodializ\u0103\" href=\"#tab-1751891c287bdcf9c07\"><h4 class=\"fusion-tab-heading\">Accesul vascular pentru hemodializ\u0103<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-accesulvascularpentruhemodializ\u0103\" id=\"tab-1751891c287bdcf9c07\">\n<p><strong>Accesul vascular pentru hemodializ\u0103<\/strong><\/p>\n<p>Un pas important \u00eenainte de \u00eenceperea tratamentului de hemodializ\u0103 este efectuarea unei interven\u021bii chirurgicale minore pentru a crea un acces vascular. Hemodializa este un tratament pentru filtrarea de\u0219eurilor \u0219i a apei din s\u00e2nge, a\u0219a cum rinichii fac c\u00e2nd sunt s\u0103n\u0103to\u0219i. Hemodializa ajut\u0103 la controlul tensiunii arteriale \u0219i la echilibrarea mineralelor importante din s\u00e2nge, precum potasiu, sodiu \u0219i calciu.<\/p>\n<p>De ce este necesar crearea unui acces vascular?<\/p>\n<p>Accesul vascular este punctul de leg\u0103tur\u0103 dintre corp \u0219i aparatul de dializ\u0103, locul unde acele sunt inserate pentru a realiza circuitul. Aparatul de dializ\u0103 lucreaz\u0103 la un debit foarte ridicat. El extrage \u0219i returneaz\u0103 \u00een organism aproape jum\u0103tate de litru de s\u00e2nge \u00een fiecare minut.<\/p>\n<p>Exist\u0103 trei tipuri de acces vascular:<\/p>\n<p>&#8211; fistula arterio-venoas\u0103 (FAV)<\/p>\n<p>&#8211; grefonul sintetic arterio-venos<\/p>\n<p>&#8211; cateterul de hemodializ\u0103<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-32 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular pentru hemodializ\u0103\" title=\"accesul vascular pt hemodializa\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-400x304.jpg\" class=\"img-responsive wp-image-2674\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/accesul-vascular-pt-hemodializa.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este fistula arterio-venoas\u0103?<\/p>\n<p>Cel mai bun tip de acces vascular pe termen lung este o fistul\u0103 arterio-venoas\u0103. Chirurgul conecteaz\u0103 o arter\u0103 la o ven\u0103, de obicei \u00een bra\u021b, pentru a crea o fistul\u0103 AV. O arter\u0103 este un vas de s\u00e2nge care transporta s\u00e2ngele oxigenat dinspre inim\u0103 spre restul corpului, iar o ven\u0103 este un vas de s\u00e2nge care readuce s\u00e2nge \u00eenapoi spre inim\u0103. Atunci c\u00e2nd chirurgul conecteaz\u0103 artera la o ven\u0103, vena respectiv\u0103 devine mai larg\u0103 \u0219i mai groas\u0103, f\u0103c\u00e2nd mai u\u0219or plasarea acelor pentru dializ\u0103. Fistula AV are, de asemenea, un diametru mare care permite s\u00e2ngelui s\u0103 curg\u0103 din corp \u00een aparatul de dializ\u0103 \u0219i \u00eenapoi \u00een corp rapid. Scopul este de a permite un flux sanguin ridicat, astfel \u00eenc\u00e2t cea mai mare cantitate de s\u00e2nge s\u0103 treac\u0103 prin dializor.<\/p>\n<p>Fistula AV este considerat\u0103 cea mai bun\u0103 op\u021biune deoarece aceasta:<\/p>\n<p>&#8211; asigur\u0103 fluxul cel mai ridicat de s\u00e2nge pentru dializ\u0103;<\/p>\n<p>&#8211; are un risc mai mic s\u0103 se infecteze sau s\u0103 se blocheze;<\/p>\n<p>&#8211; are o durat\u0103 de via\u021b\u0103 mai lung\u0103.<\/p>\n<p>Majoritatea pacien\u021bilor pot merge acas\u0103 imediat dup\u0103 interven\u021bie, \u00een aceea\u0219i zi. Opera\u021bia se realizeaz\u0103 de obicei \u00een anestezie local\u0103, fiind amor\u021bit\u0103 doar zona \u00een care chirurgul creeaz\u0103 fistula AV, dar, \u00een func\u021bie de situa\u021bia pacientului, se poate opta pentru anestezie general\u0103.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-33 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular\" title=\"hemodializa 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/hemodializa-2-400x304.jpg\" class=\"img-responsive wp-image-2675\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este grefonul arterio-venos?<\/p>\n<p>Dac\u0103 venele nu permit realizarea unei fistule AV, se poate opta pentru implantarea unui grefon AV. \u00cen acest caz, chirurgul utilizeaz\u0103 un tub artificial pentru a conecta o arter\u0103 la o ven\u0103. Un grefon AV pentru dializ\u0103 poate fi utilizat la scurt timp dup\u0103 interven\u021bia chirurgical\u0103.<\/p>\n<p>Cu toate acestea, exist\u0103 un risc mai ridicat de infec\u021bie \u0219i de formare a cheagurilor de s\u00e2nge \u00een grefon. Cheagurile pot bloca fluxul de s\u00e2nge prin grefon \u0219i pot face dificil\u0103 sau imposibil\u0103 dializa.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-34 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular hemodializ\u0103\" title=\"hemodializa\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/hemodializa-400x304.jpg\" class=\"img-responsive wp-image-2677\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Ce este cateterul de hemodializ\u0103?<\/p>\n<p>Dac\u0103 boala de rinichi progreseaz\u0103 rapid \u0219i nu este timp pentru efectuarea unei proceduri de acces vascular \u00eenainte de dializ\u0103, este necesar\u0103 implantarea unui cateter venos &#8211; un tub mic \u0219i moale inserat \u00eentr-o ven\u0103 \u00een g\u00e2t, piept sau picior, ca acces temporar.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-35 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular hemodializ\u0103\" title=\"hemodializa 3\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/hemodializa-3-400x304.jpg\" class=\"img-responsive wp-image-2676\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/hemodializa-3.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div><\/div><div class=\"nav fusion-mobile-tab-nav\"><ul class=\"nav-tabs\" role=\"tablist\"><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-eae55148d86c9d9871f\" aria-selected=\"false\" tabindex=\"-1\" id=\"mobile-fusion-tab-accesulvascularpentruchimioterapie\" href=\"#tab-eae55148d86c9d9871f\"><h4 class=\"fusion-tab-heading\">Accesul vascular pentru chimioterapie<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-accesulvascularpentruchimioterapie\" id=\"tab-eae55148d86c9d9871f\">\n<p><strong>Accesul vascular pentru chimioterapie<\/strong><\/p>\n<p><strong>\u00a0<\/strong>O camer\u0103-port este un dispozitiv mic de acces venos, aproximativ de m\u0103rimea unei monede, folosit pentru a administra medicamente \u00een s\u00e2nge. Este implantat\u0103 sub piele, de obicei \u00een partea superioar\u0103 a pieptului. Porturile sunt utilizate la pacien\u021bii care necesit\u0103 administrarea frecvent\u0103 de chimioterapie, transfuzii de s\u00e2nge, antibiotice, hr\u0103nire intravenoas\u0103 sau recolt\u0103ri de s\u00e2nge frecvente pentru analize. Dispozitivul este format din corpul portului \u0219i un cateter. Corpul portului are una sau mai multe camere distincte care sunt sigilate cu un capac moale (sept), siliconic, care poate fi str\u0103puns cu ace speciale. Un cateter moale, din plastic, se conecteaz\u0103 la corpul portului \u0219i v\u00e2rful cateterului este plasat \u00eentr-una din vene centrale mari din piept, care transporta s\u00e2nge \u00een inim\u0103.<\/p>\n<p>Care sunt avantajele unei camere-port?<\/p>\n<p>Un port are urm\u0103toarele avantaje:<\/p>\n<p>&#8211; r\u0103m\u00e2ne implantat luni sau ani, \u00een func\u021bie de c\u00e2t timp este necesar;<\/p>\n<p>&#8211; reduce num\u0103rul de \u00een\u021bep\u0103turi \u00een vene pentru a recolta s\u00e2nge sau a infuza medicamente sau lichide;<\/p>\n<p>&#8211; reduce durerea \u0219i timpul petrecut \u00een \u00eencercarea de a accesa o ven\u0103 adecvat\u0103;<\/p>\n<p>&#8211; medicamentele administrate sunt diluate de s\u00e2nge, lez\u00e2nd mai pu\u021bin peretele venos;<\/p>\n<p>&#8211; mai multe tipuri de medicamente sau alte tratamente pot fi administrate \u00een acela\u0219i timp cu ajutorul unui port cu dou\u0103 camere.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-36 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Chirurgie vascular\u0103 Timi\u0219oara\" title=\"chimioterapie\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/chimioterapie-400x304.jpg\" class=\"img-responsive wp-image-2679\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapie.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<p>Cum se realizeaz\u0103 interven\u021bia de implantare?<\/p>\n<p>Opera\u021bia de implantare a camerei-port este o procedur\u0103 scurt\u0103, efectuat\u0103 sub anestezie local\u0103 \u0219i \u00een condi\u021bii sterile. Zona \u00een care va fi inserat portul este sterilizat\u0103, apoi amor\u021bit\u0103 cu un anestezic local. \u00cen timpul procedurii, chirurgul face o\u00a0 incizie de 4-5 cm la baza um\u0103rului. Pe aceast\u0103 incizie identific\u0103 vena subclavie, \u00een care introduce cateterul. Apoi chirurgul face un buzunar sub piele, \u00een care corpul portului va fi plasat \u0219i securizat, apoi conectat la cateter. Incizia va fi \u00eenchis\u0103 cu suturi resorbabile.<\/p>\n<div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-37 hover-type-none\" style=\"border:5px solid #d5a748;\"><img width=\"400\" height=\"304\" alt=\"Acces vascular\" title=\"chimioterapia 2\" src=\"http:\/\/tell.agency\/medcom\/wp-content\/uploads\/2020\/08\/chimioterapia-2-400x304.jpg\" class=\"img-responsive wp-image-2678\" srcset=\"https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2-200x152.jpg 200w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2-400x304.jpg 400w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2-600x456.jpg 600w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2-800x608.jpg 800w, https:\/\/medcom.ro\/wp-content\/uploads\/2020\/08\/chimioterapia-2.jpg 1000w\" sizes=\"(max-width: 640px) 100vw, 400px\" \/><\/span><\/div>\n<\/div><\/div><\/div><\/div><style type=\"text\/css\">.fusion-body 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