Alternative Diagnostic Tests and Therapeutic Interventions Flashcards
what is arteriography?
xray imaging of the arteries that uses contrast medium
2 types of arteriography
intra-arterial injection
digital subtraction angiography (DSA)
how does digital subtraction angiography (DSA) work?
uses real-time digital video processing to detect small amounts of radiopaque contrast medium within vessels
removes bones and other static structures that could limit visualization of the vessels
what is the purpose of arteriography?
evaluate peripheral and abdominal arteries in patients with suspected vascular disorder
4 limitations of arteriography
- allergy to contrast (iodine)
- cannot provide multiple images in multiple planes in real time
- good images of lumen, but not the vessel wall
- poor kidney function to excrete contrast agent
5 complications of arteriography
puncture site hematoma
localized numbness at puncture site
pseudoaneurysm
local arterial occlusion
renal dysfunction
arteriography intra-arterial injection uses the ___ technique
Seldinger technique
percutaneous puncture of a superficial artery and insertion of a very thin catheter
the most commonly used arteries for an arteriography are (3)
CFA
axillary
brachial
arteriography
when removing the catheter, hemostasis is achieved with (2)
manual compression
vascular closure device
T/F: arteriography is a functional study
FALSE
it is NOT a functional study
arteriography
normal anatomy of vessel
contrast medium will completely fill the vessel
arteriography interpretation is based on ___
how much (if any) of the artery does not fill with the contrast agent
arteriography
atherosclerosis appearance (2)
plaque appears as irregular or smooth negative images
collaterals are usually present in cases of long-standing occlusion
arteriography
aneurysm appearance (2)
thrombus may develop along the dilated wall creating the appearance of a straight tube
lack of arterial branches, elongation, and tortuosity
arteriography
fibromuscular dysplasia appearance
multiple arterial stenoses appear as a “string of beads”
fibromuscular dysplasia more often is located in the ___
mid to distal renal artery
___ and ___ both use radiofrequency energy and a strong magnetic field to produce multiplanar images
magnetic resonance imaging (MRI)
magnetic resonance angiography (MRA)
MRI is excellent for evaluating ___
anatomic structures
MRA can quantify ___ and construct images that look like angiograms
blood flow
MRA without contrast agents can distinguish ___ from ___
blood flow from soft tissue
purpose of MRI and MRA is to evaluate (3)
AAA
dissection
peripheral arterial disease
MRI and MRA limitations (6)
- pacemakers, monitoring equipment, metallic objects
- degree of stenosis is difficult to assess
- stenoses may be overestimated
- more expensive than ultrasound
- claustrophobia
- interpretation requires considerable skill
computed tomography (CT) uses ___ to obtain cross-sectional images of anatomic structures with or without contrast agents
ionizing radiation
computed tomography angiography (CTA) provides better visualization of ___
vasculature
CT and CTA purpose (3)
- help define the relationship of the aorta to RA origins
- determine whether an aortic aneurysm is present
- assess for presence/location of dissection
CT and CTA limitations (4)
- images are degraded with patient motion and presence of surgical clips
- requires more time and is expensive
- limited application in peripheral arterial disease
- renal insufficiency
CT and CTA
3D reconstruction provides the exact ___ and ___ of vessels related to the aneurysm
contour and measurement
relationship of ___ to AAA is critical in planning surgical or endovascular intervention
renal arteries
