Ch. 23 Vascular Flashcards
Color duplex ultrasonography can differentiate
aortic aneurysm from tortuous vessels
AAAs occur more frequently in ______ and are mostly located
older men, inferior to renal arteries
AAAs are commonly associated with iliac, femoral and popliteal aneurysms. What percentage represents popliteal aneurysms
20%
AAAs are commonly associated with what 3 aneurysms
iliac, femoral and popliteal
What is an indication for aortoiliac duplex exam
emboli in ischemic digits (blue toe syndrome)
What is another name for emboli in ischemic digits
blue toe syndrome
When preparing for an aortoiliac scan, the patient should
fast overnight for 8-12 hours
Besides supine, what are other patient positions that can be used
RLD or LLD
What transducers are most used for AI duplex exam
lower frequency
What might you do to ensure a high resolution with good color flow and spectral doppler
use multiple transducer approaches, find windows
in AAA protocol, diametermeasurements may include both ____ and left to right ______ dimensions
AP, lateral
In AAA protocol, what dimensions are less reliable due to edge drop-off
lateral
In AAA protocol, care must be taken to be sure that measurements are taken
perpendicular to the vessel
In AAA protocol, a _____ flow component in early diastole should be present in
reverse / CIA, EIA and distal abdominal aorta
______ waveform at the CFA ______ to an ______ occlusion likely means _______ system in place
multiphasic, ipsilateral, iliac artery, collateralization
Stents should be evaluated for
alignment, full deployment, relationship to vessel wall
Walls of stents should be _____ to walls of vessel
opposed
Normal aortic diameter
<2cm
What diameter is consistent with aneurysm
> 3cm
Focal diameter increasing by more than ____ of normal segment is consistent with aneurysm
50%
TRUE aneurysms involve
all three layers of vessel wall
AAA most commonly involve
distal aorta (infrarenal)
What are the two types of AAA
fusiform, saccular
Saccular AAAs have
asymmetric outpouching dilations
Saccular AAAs are often caused by what two things
trauma, penetrating aortic ulcers
What is the most common aneurysm complication
rupture
Dissection is associated with
two flow channels
In a stenosis or occlusion, thrombus is often
homogeneous with smooth borders
Thrombus is often found
within aneurysm sac
In stenosis or occlusion, ______ waveforms may remain fairly normal with presence of extensive _______
distal, collateralization
In aortoiliac duplex ultrasound following EVAR, it excludes
aneurysm from general circulation
Flow present within aneurysm sac after intervention
endoleak
Endoleaks have a risk of
rupture
Endoleak presence can _____ pressure in aneurysm sac, continuing to make rupture a risk
increase
CDU for follow up can accurately
monitor residual aneurysm sac size and detect graft limb dysfunction and kinking
What is frequent in CDU for follow up
trade off and long term survelliance
EVAR complications
PA, hematomas, stenosis
B mode characteristics in the residual aneurysm sac after successful EVAR are usually
homogeneous
When scanning EVAR, color is helpful in
localization of vessels, following deep/tortuous vessels and aiding in aligning doppler gate
Residual sac size should what over time
decrease
What is the most compelling evidence of success after EVAR
decrease in residual sac size over time
How many types of endoleaks are there
4
What is type I endoleak
ineffective steal at attachment site
What is type II endoleak
retrograde flow in branch (lumbar) vessel
What is type III endoleak
modular disconnection or defect in graft fabric
What is type IV endoleak
porous graft or microleak in graft material
What has reproducible arterial waveforms DIFFERENT from flow within endograft
perigraft leaks
What can you do to help identify endoleaks
change patient position from supine to RLD/LLD, optimize color settings (decrease PRF), use power doppler
When identifying endoleaks, what can you do to optimize the color settings
decrease PRF, increase persistence and gain
