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MIDS 237 > Ch 15 Ao + iliac arteries > Flashcards

Ch 15 Ao + iliac arteries Flashcards

1
Q

What is an endoleak?

A

The continued blood flow into an excluded aneurysm after endovascular placement of a stent graft

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2
Q

What is an endovascular aneurysm repair?

A

Form of minimally invasive surgery where a stent graft is placed inside an aneurysm, providing a new channel for blood flow + excludes flow from the dilated walls of the artery

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3
Q

Differentiate fusiform + saccular?

A

Fusiform: elongated + spindle shaped, circumferential widening of Ao (m/c)

Saccular: sac-like or pouch-like bulging of 1 wall, due to infection, trauma, or penetrating ulcer

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4
Q

What is a stent?

A

Tube like structure placed inside a blood vessel to provide patency + support

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5
Q

What are the branches off the descending thoracic Ao?

A

Bronchial, esophageal, phrenic, intercostal + subcostal arteries

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6
Q

What level of the spine does the abdominal Ao begin at?

A

T12 - passes through aortic hiatus of diaphragm

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7
Q

What are the 3 anterior branches of the abdominal Ao?

A

-Celiac artery (1-2cm long)
-SMA (1cm below CA)
-IMA (3-4cm above Ao bif)

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8
Q

The celiac artery gives rise to which 3 arteries?

A

HA, SA + LGA

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9
Q

What does the SMA supply + what course does it take?

A

-Supplies the small intestine + part of large
-Courses inferiorly, running parallel + anterior to the Ao

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10
Q

What does the IMA supply?

A

Large intestine

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11
Q

What is the seagull sign?

A

CA, HA, SA

(LGA not seen)

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12
Q

List the lateral + paired branches of the abdominal Ao?

A

-Renal arteries (1-2cm below SMA)
-Gonadal arteries: testicular + ovarian arteries (branch off below RAs)

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13
Q

List the posterior branches of the abdominal Ao?

A

-Lumbar arteries (4 pairs, sometimes 5)
-Middle sacral artery

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14
Q

Which renal artery is longer + higher?

A

RT (courses posterior to IVC to get to RK)

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15
Q

The renal arteries enter the kidneys posterior or anterior to the renal veins?

A

Posterior

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16
Q

Course of lumbar arteries?

A

Lateral + posterior to lumbar vertebrae

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17
Q

What is the middle sacral artery?

A

-Small branch that arises just above Ao bif
-Supplies sacrum, coccyx + lumbar vertebrae

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18
Q

The abdominal Ao bifurcates at what level of the spine?

A

L4 (into the RT + LT common iliac arteries)

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19
Q

The CIA’s bifurcate into what?

A

Internal + external iliac arteries

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20
Q

What does the IIA + EIA supply?

A

IIA (aka hypogastric arteries): pelvic organs

EIA: continues distally to supply lower extremities

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21
Q

___ arteries become the common femoral arteries once they cross the inguinal ligament?

A

EIA’s

22
Q

M/c location of a AAA?

A

Infrarenal (below renal arteries)

23
Q

AAAs are m/c in men or women?

A

Men

24
Q

___ aneurysms are associated with AAAs?

A

Common iliac, femoral or popliteal aneurysms

25
Q

___ increases the risk of having a AAA by 5x?

A

Smoking

26
Q

What is the AAA protocol?

A

Images of Ao + iliac arteries with b-mode + CD in both planes (protocols vary with each site)

27
Q

How do we measure the Ao?

A

Outer to outer

28
Q

If the AAA protocol includes spectral doppler, how should we set our doppler parameters?

A

SVB: 1.5-2mm
Doppler Angle: 45-60 degrees

29
Q

U/s reports must include the diameter of the Ao + CIA if ___?

A

Ectactic/aneurysmal

30
Q

If a focal aneurysm is found, we must note its proximity to ___?

A

The renal arteries

31
Q

List 4 other findings associated with a AAA?

A

-Wall defects
-Penetrating ulcers
-Intimal tears
-Dissections

32
Q

What is the normal infrarenal Ao diameter?

A

<2cm

33
Q

What is ectasia?

A

-Mild diffuse enlargement of Ao, secondary to degeneration of the wall
-Use this term when Ao measures <3cm

34
Q

What is the measurement for a true Ao aneurysm?

A

When Ao dilates >3cm + involves all 3 layers of vessel wall

35
Q

What is the measurement for an ectatic + aneurysmal CIA?

A

Ectatic: >1.5cm
Aneurysmal: >2cm

36
Q

What is an ABI + ABF graft?

A

ABI: aortobiliac graft

ABF: aortobifemoral graft

37
Q

What is the AAA post-op protocol?

A

2D, CD + spectral doppler velocities obtained of the Ao, anastomosis, graft + CIAs

(diameters taken prox + dist to graft to rule out pathologies)

38
Q

What is an EVAR?

A

-Endovascular aortic aneurysm repair
-Stent graft device placed in AAA via catheter
-Is anchored with stents in the non-aneurysmal arteries prox + dist to the AAA (reduces risk of rupture)

39
Q

SF of graft fabric?

A

Hyperechoic area along the ant + post walls of Ao lumen, just below RAs

40
Q

What is AIOD?

A

-Aortoiliac occlusive disease
-Is stenosis in the Ao or CIAs due to atherosclerotic plaque

(20% pt’s with AAA have AIOD)

41
Q

AOID protocol?

A

-Image Ao + iliac arteries in 2D + CD in both planes
-Measure prox/mid/dist Ao, CIAs + EIAs
-Take velocities (if elevated, take another velocity prox + dist to that area)

42
Q

Occlusive disease often starts near what structure?

A

Ao bif, extends into CIAs + EIAs, then into femoral arteries

43
Q

How would an occluded area appear?

A

No CD flow + spectral doppler will show a thump artifact

44
Q

How to calculate aortoiliac stenosis?

A

PSV in stenosis/ PSV prox to stenosis

(a doubling in velocity b/w these segments indicates 50-99% stenosis)

45
Q

What are we looking for distal to a stenosis?

A

Turbulence or tardus parvus waveform

46
Q

Waveform above renal arteries?

A

Low resistance (high diastolic flow) with antegrade flow in diastole

47
Q

Waveform of distal Ao?

A

Higher resistance with low end diastolic flow

48
Q

Waveform of common, external + internal iliac arteries?

A

Multiphasic with flow reversal below baseline in early diastole

49
Q

M/c type of open repair for a AIOD?

A

ABF graft

50
Q

PSV >300 cm/s in a stent with post-stenotic turbulance indicates what?

A

> 50% stenosis

51
Q

EDV >150 cm/s in a stent with post-stenotic turbulance indicates what?

A

> 80% stenosis

MIDS 237 (23 decks)

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