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Vascular I & Physics I > Ch. 14-16 Vascular > Flashcards

Ch. 14-16 Vascular Flashcards

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1
Q

What vessels are used for autogenous vein bypass graft

A

GSV usually, but can also use SSV or cephalic V

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2
Q

Orthograde BG involves

A

lyzing valves

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3
Q

Retrograde BG involves

A

flipping the vein

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4
Q

When you flip the vein, valves

A

do not need to be removed

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5
Q

How is a vein flip performed

A

large end of the vein anastomosed to small end of artery (and vice versa)

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6
Q

When you flip the vein, it is completely

A

removed from its nature tissue bed

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7
Q

During the first 30 days, what technical problems are more likely to occur with bypass graft failure

A

retained valve, intimal flap, graft entrapment

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8
Q

Patients who need more frequent surveillance are

A

intraoperative revision

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9
Q

What is the proper doppler technique when scanning bypass graft

A

60-degree angles or less, place sample volume in center of vessel, sample volume should be small

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10
Q

If angles less than 60 degrees are used in previous exams,

A

angles should be duplicated in follow-up exams

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11
Q

If both antegrade and retrograde are seen, it is most likely indicative of

A

retrograde flow through prox outflow artery

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12
Q

What is most likely to occur any point along bypass conduit

A

myointimal hyperplasia

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13
Q

Aneurysms can be

A

focal or diffuse

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14
Q

What should be used to document flow within incidental findings

A

color

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15
Q

What may be present with color imaging in a stenosis

A

aliasing

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16
Q

color can mask

A

small wall defects

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17
Q

What are the normal bypass waveform characteristics

A

multi-phasic, sharp upstroke and narrow systolic peak, HIGH RESISTANCE WF CHARACTERISTICS, REVERSE FLOW IN EARLY DIASTOLE

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18
Q

Occurs when branch of great saphenous vein is left unligated

A

arteriovenous fistula

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19
Q

Abnormal connection between artery and vein

A

arteriovenous fistula

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20
Q

What is the doppler spectrum PROXIMAL to fistula

A

will display low resistance pattern with continuous antegrade flow in diastole

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21
Q

What is the doppler spectrum DISTAL to fistula

A

little to no diastolic flow will be present

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22
Q

Spectral analysis of distal stenosis or occlusion can progress to

A

staccato waveform

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23
Q

What is the indicator of a staccato waveform

A

minimal forward flow in systole

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24
Q

What is the criteria for stenosis categorization

A

PSV ratio of 3.5 and PSV >300 cm/s consistent with a greater than or equal to 75% stenosis

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25
Q

What is the normal mean graft flow velocity (GFV)

A

greater than 45 cm/s

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26
Q

A decrease in GFV ______ indicates pending graft failure

A

> 30 cm/s

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27
Q

What does PTA stand for

A

percutaneous transluminal angioplasty

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28
Q

What is the most common endovascular treatment

A

PTA

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29
Q

What is the process for precutaneous transluminal angioplasty (PTA)

A

passage of a guidewire, inflation or a balloon or deployment of a stent (or both)

30
Q

Outcome of endovascular intervention is largely dependent on

A

procedure indication, lesion severity and location

31
Q

Approx _______ of angioplasty sites will require

A

33% (1/3), re-intervention to maintain patency within the 1st year

32
Q

What will you see in a post stent procedure

A

decrease in wall compliance

33
Q

What provides a more precise assessment of functional patency

A

ultrasound testing

34
Q

In claudicant, _____ should improve greater than _____ post procedure

A

ABI, 0.9

35
Q

What is the abnormal acceleration time for CFA

A

200 m/sec

36
Q

Tibial waveforms at least at the ankle should also be obtained. (If _______, imaging of _______ site not necessary)

A

multiphasic, angioplasty

37
Q

Criteria for determining severity of stenosis primarily uses

A

PSV and velocity ratio

38
Q

VR calculation=

A

PSV at stenosis divided by PSV just prox to stenosis

39
Q

PSV value may be higher due to _______. why?

A

Myointimal hyperplasia, (non-uniform wall stress)

40
Q

Duplex findings on in-stent stenosis include

A

reduction in ABI > .15 mmHg

41
Q

Once an angioplasty site thromboses then undergoes another procedure, the

A

outcome states are termed secondary patency

42
Q

What is the inflammatory process involve for vascular arteritis

A

medial layer of vessel wall becomes infiltrated with white blood cells

43
Q

What does the inflammatory process for vascular arteritis appear as

A

a halo

44
Q

What are the symptoms of vascular arteritis

A

claudication/rest pain, decreased asymmetrical bp, TIA/stroke symptoms, dizziness, syncope

45
Q

What is giant cell arteritis vascular arteritis also called

A

temporal arteritis

46
Q

What age and gender is temporal arteritis typically seen

A

elderly white women

47
Q

Temporal arteritis can cause visual disturbances such as

A

optic nerve ischemia and is considered a medical emergency

48
Q

What may be present in temporal/giant cell arteritis and what does it appear as

A

anechoic area surrounding vessel, producing a halo

49
Q

What causes the halo in temporal/giant cell arteritis

A

accumulation of WBCs

50
Q

What is highly specific for takayasu arteritis, more common in the CCA

A

macaroni sign

51
Q

What is another name for thromboangiitis obliterans

A

buerger disease

52
Q

What does buerger disease affect

A

small and medium vessels of upper and lower extremities

53
Q

What is present in buerger disease

A

digital ischemia, ischemic digital ulcers

54
Q

What percent of patients will demonstrate symptoms? and in how many extemities

A

more than 80%, 3 of 4

55
Q

What is always present in clinical history of buerger disease

A

tobacco abuse

56
Q

What can be used as a scanning technique for buerger disease

A

PVR waveforms as well as pressure testing

57
Q

Scanning technique can invlove ______ or ______ for buerger disease

A

upper or lower extremity

58
Q

All of the exam except what may appear normal for buerger disease

A

digital evaluation

59
Q

Radiation-induced arteritis results in

A

perivascular fibrosis, inflammation and acceleration of atherosclerosis

60
Q

Radiation induced arteritis may be difficult to distinguish from

A

atherosclerosis

61
Q

Why is rad induced arteritis difficult to distinguish from atherosclerosis

A

localization, focal nature, and absence of other atherosclerotic disease points to radiation cause

62
Q

What is embolic disease

A

occlusion or obstruction of an artery by a transported clot of blood or mass, bacteria or other foreign object

63
Q

In cardioembolic disease, approximately _______ of arterial emboli are from a ____ source

A

80-90%, cardiac

64
Q

Pulsating encapsulated hematoma that communicates with adjacent artery

A

pseudoaneurysm

65
Q

Pseudoaneurysms occur from

A

leakage of blood after injury into soft tissue

66
Q

PA most commonly occurs in the ______ as a result of _______

A

CFA, catheter-based procedures

67
Q

PA can occur after ________, after _______ or with

A

blunt or penetrating trauma, bypass grafting, dialysis grafts or fistulas

68
Q

Abnormal connection between artery and vein

A

arteriovenous fistula

69
Q

What is a sign and symptom of an arteriovenous fistula

A

palpable thrill

70
Q

In popliteal artery entrapment syndrome, repeated compression of pop artery can produce

A

aneurysm formation, thromboembolism or arterial thrombosis

71
Q

Scanning technique of nonatherosclerotic arterial aneurysms include

A

measure vessel diameter proximal and distal to area of suspected dilation

72
Q

When scanning for nonatherosclerotic arterial aneurysms, if the vessel diameter increases at least _____ as compared to ______ segment is consistent with _____

A

50%, normal, aneurysm

Vascular I & Physics I (19 decks)

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