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Vascular I & Physics I > Ch. 9 Vascular > Flashcards

Ch. 9 Vascular Flashcards

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1
Q

Traditional carotid endarterectomy (CEA) surgical procedure

A

open operation / arteriotomy made ICA / material is removed / opening is closed / place patch

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2
Q

Common problems associated with CEA

A

narrowing of vessel / plaque that wasn’t removed / NEOINTIMAL HYPERPLASIA as surgical site

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3
Q

Restenosis is

A

neointimal hyperplasia at surgical site

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4
Q

Surgical patches are used to enlarge surgical site and

A

reduce the potential for a stenosis by widening the lumen

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5
Q

With surgical patches, why are veins often everted

A

allows double wall thickness and vein intima to face lumen of artery

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6
Q

Why is eversion different from a CEA

A

ICA is transected at bifur and evertesd to peel plaque from wall / does not require a patch / less obvious on US

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7
Q

In eversion, sutures will appear

A

circumferentially around the ICA

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8
Q

What is the primary concern of these surgeries

A

restenosis / residual plaque / suture narrowing / thrombosis or occlusion

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9
Q

Dacron patch has

A

woven appearance

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10
Q

PTFE patch has

A

two bright echogenic lines

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11
Q

Vein patch resmbles

A

native wall

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12
Q

After surgery with synthetic patch, neck swelling may be caused by

A

hematoma, infection or pseudoaneurysm

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13
Q

After surgery with vein patch, neck swelling may be caused by

A

patch rupture

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14
Q

Post CEA infection is associated with

A

encap masses / perivascular fluid / neck swelling / extravasated blood

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15
Q

Pitfalls in US post surgery

A

complicated exam during postoperatively period

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16
Q

Why is it hard to examine post surgery for patches

A

air entrapped in patch / wound hematoma / synthetic patch

17
Q

Complications with diagnosis and patches include

A

suture disruption / suture hole bleeding / pseudoaneurysm

18
Q

Non-stenotic pathology includes

A

oversized/irregular patch / loose strands of suture / intimal flap / embolization/occlusion

19
Q

Stenotic problems within 1 month post surgery

A

narrowing of closure / shelf lesion / thrombus

20
Q

Remnant plaque is also called

A

shelf lesion

21
Q

Restenosis problems include

A

narrowing in the first 24 months considered neointimal hyperplasia / possible occlusion

22
Q

After 2 years, stenosis considered

A

atherosclerotic

23
Q

Catheter access for carotid artery stenting is usually through the

A

common femoral artery

24
Q

Complications from stents that occur in carotid system and pathway of catheter are

A

dissection / thrombosis / perforations

25
Q

What is commonly used prior to stent placement

A

embolic protection device (EPD)

26
Q

Stenting procedure

A

pre-dilation with angioplasty balloon / self expanding stent placement followed by balloon

27
Q

Stent must cover ____ lesion and extend ____ beyond proximal and distal margins of lesion

A

full, 5mm

28
Q

What is most common post stent placement issue and what %

A

stent border stenosis, 40%

29
Q

What is a pitfall in stent placement

A

atherosclerotic plaque is not removed

30
Q

What happens when the atherosclerotic plaque is not removed

A

dense calcification and shadowing

31
Q

Dense plaquing may result in

A

problems placing stent / restricts balloon / increase hyperplasia

32
Q

Stent fracture and migration is strongly associated with

A

calcifications

33
Q

Restenosis rates after CAS may be

A

40% higher than CEA

34
Q

In stent restenosis ______ may be an ongoing response to implanted foreign object

A

hyperplasia

35
Q

Hyperplasia can occur across

A

middle of stent, proximal attachment sire or distal attachment site

36
Q

What is seen with diabetes with stent placement

A

aggressive initial hyperplasia and in stent restenosis

37
Q

Changes in velocity after placement

A

elevated velocity and reduces arterial compliance

38
Q

Primary discriminator for significant stenosis is the

A

peak systolic velocity

39
Q

What is the PSV threshold for 50% stenosis

A

175-240 cm/s

Vascular I & Physics I (19 decks)

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