Ch 108 - Vascular Surgery Flashcards

1
Q

What are the three layers of blood vessels and how do they differ in arteries and vein?

A
  • Tunica externa/adventitia - Connective tissue fibroblasts and collagen. This layer needs to be removed from the cut ends for vessel reconstruction
  • Tunica media - Smooth muscle cells and elastic tissue
  • Tunica intima - Endothelial cells

The tunica media of a vein is thinner than that of an artery

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2
Q

What veins carry oxygenated blood?
Where are the only venous sinuses located?

A
  • Pulmonary veins and umbilical vein
  • In the skull
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3
Q

Name the following instruments

A

From left to right:
- Diamond-jawed needle holder
- DeBakey atraumatic forceps
- Metzembaum scissors
- Potts scissors
- Small and large right-angled forceps

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4
Q

Name the following microvascular instruments

A

From left to right:
- Miscrovascular needle holders, without catch
- Curved Vannas microvascular dissecting scissors
- Straight adventitial scissors
- Jeweler’s forceps
- Curved and straight mosquito haemostats

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5
Q

What sized suture is recommended in vascular surgery?

A

3-0 to 10-0
- Vessels with internal diameter of 4-6mm - 4-0/5-0
- 2-3mm - 6-0
- less than 2mm - 7-0/8-0

Nylon or polypropylene for arteries
Braided multifilament passed through mineral oil or bone wax for veins

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6
Q

What is the most common biological vascular graft in veterinary patients?

A

Jugular vein

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7
Q

What is the characteristic pattern on a perfused artery?

A

Vaso vasorum

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8
Q

List the main options for anticoagulation in vascular surgery

A
  • Unfractionated heparin
  • Enoxaparin
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9
Q

List the options for incision orientation for venotomy/arterotomy

A
  • Longitudinal
  • Transverse (recommended in vessels under 4mm diameter)
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10
Q

List the three options for vascular anastomosis

A
  • End-to-end
  • End-to-side
  • Side-to-side
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11
Q

What is Kunlin’s technique?

A

Placing a horizontal mattress suture during vascular anastomosis to produce mild eversion and improve intima approximation

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12
Q

What is the most common guide wire size used in endovascular surgery?

A
  • 0.035 inch (0.012-0.052)
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13
Q

What sized vascular sheath is most commonly used?

A

5-6Fr

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14
Q

What vessels are typically used for access during endovascular procedures?

A
  • Femoral or carotid artery
  • Jugular vein
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15
Q

List some endovascular techniques used in small animals

A
  • Central venous catheter placement
  • Subcutaneous venous access port
  • Embolotherapy and embolectomy
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16
Q

What substances can be used for embolotherapy?

A

Non-absorbable
- Polyvinyl alcohol
- Trisacryl gelatin microspheres
- Silk suture

Absorbable:
- Gelatin sponges
- Autogenous blood clot material

Liquid:
- Cyanoacrylate and Lipiodol

Mechanical:
- Metallic coils
- Ductal occluders

17
Q

List options for embolectomy

A
  • Direct surgical removal
  • Embolectomy balloon catheter
  • Catheter directed thrombolytic therapy (tissue plasminogen activator)
  • Rheolytic catheter (pulsatile, high velocity stream of saline)
  • Stents - may be used in combo with thrombolytic therapy
18
Q

List potential caused of acquired AV fistulas

A
  • Poorly treated arterial injuries
  • iatrogenic en bloc ligation
  • traumatic arterial catheterisation
  • Extravasation of irritating substances
  • Trauma
  • Infection
  • Neoplasia
  • Surgically created for long-term venous access
19
Q

List options for treatment of AV fistulas

A
  • Cyanoacrylate glue embolisation
  • Ligation and division of the artery proximal and distal to communication