Chap 87-91 Open Endovascular Technique

Question 1

List occlusive clamps.

Answer 1

Debakey aortic aneurysm clamp
Fogarty aortic clamp
Lambert-kay aortic clamp
Wylie hypogastric clamp

Question 2

List partially occluding clamps.

Answer 2

Lemole-strong aortic clamp
Statinsky
Cooley anastomosis

Question 3

List self compressing clamps.

Answer 3

Potts bulldog
Debakey bulldog
Dietrich bulldog

Question 4

List different needle types.

Answer 4

Calcific CC
Small BV
Medium C1
Large RB-1
Large aorta v7
Large MH

Question 5

List when to use what size fogarty.

Answer 5

2F small vessel pedal/hand
3F tibial
4F pop/SFA
5F external iliac
6-7 graft saddle aortic

Question 6

List adjunct to localizeing th eCFA for puncture.

Answer 6

palpation/landmarks
fluoro
US

Question 7

What is the gauge of a puncture needle? micro puncture?

Answer 7

18 gauge (0.035)
21 gauge (0.018)

Question 8

What is the pressure limit for flow through a multi holed and end hole catheter?

Answer 8

900 PSI

300-500 PSI

Question 9

List different flush catheters.

Answer 9

pigtail
omni
straight

Question 10

List different single curved.

Answer 10

kumpe
Bernstein
MPA
MPB

Question 11

List different double curved.

Answer 11

C1
C2
C3
head hunter
Rim
mammary
judkins

Question 12

List diffferent reverse curve

Answer 12

SOS
VS1-3
simmons

Question 13

Name different crossing catheters.

Answer 13

quick cross
trailblazer
crosscath
minnie

Question 14

What is nominal pressure?

Answer 14

Pressure required to expand the balloon to stated diameter

Question 15

What is rated burst pressure?

Answer 15

Pressure at which 99.9% of balloons tested will not burst

Question 16

What is compliance?

Answer 16

Amount a balloon will expand beyond its diameter as inflation pressure is increased

Question 17

Do lower compliance balloon have higher or lower burst P?

Answer 17

lower

Question 18

What is trackability?

Answer 18

Ability to follow course of guide wire

Question 19

What is push ability?

Answer 19

Columnar force transmitted to shaft of balloon catheter to tip of balloon

Question 20

What size balloon for CIA?
EIA?
SFA?
pop?
tibial?

Answer 20

6-10
6-8
5-7
4-6
2-3

Question 21

List three devices used for crossing CTO?

Answer 21

corsser device (vibrate)
truepath (rotational)
frontrunner (articulating)

Question 22

What are pros for BE?

Answer 22

high radial force/ongitudinal force
precise placement
further expansion with larger balloons
radioopaque

Question 23

What are cons for BE?

Answer 23

short lengths, prone to crushing

Question 24

What are pros for SE?

Answer 24

flexible, longer length
continued radial force ir oversize
crush resistant
ability to clamp stent

Question 25

What are cons for SE?

Answer 25

low radial force less precise limited radioopacity

Question 26

What are indications for secondary stenting?

Answer 26

``` Dissection Residual stenosis Pressure gradient Occlusion Recurrence ```

Question 27

What are indication for primary stenting?

Answer 27

Heavily calcified ostial lesions Renal, mesenteric Brachiocephalic Aortic bifurcation

Question 28

What are relative indications for aorta-uni?

Answer 28

Very small terminal aorta <15mm Severe unilateral iliac occlusive disease Secondary treatment of a short-body endograft migration

Question 29

What are some anatomical considerations for EVAR?

Answer 29

``` neck 10-15mm neck diameter accomodate 10-20% oversize angulation <20mm iliac coverage 2cm careful thrombus, conical, calcified, posterior bulges in neck ```

Question 30

what are relative CI for perch closure?

Answer 30

``` severly scarred groins high fem bifurcation frequen introducer changes significant prox iliac occlusive disease small ilio fem anterior calcific femoral ```

Question 31

What are adjunct to facilitate contra limb cannulation?

Answer 31

``` don’t loose wire access on contra side/may be difficult to regain if tortuose choose steerable angled wire oblique fluoro view antegrade access from brachial convert to aorto-uni ```

Question 32

What to look for on completion angio?

Answer 32

confirm patency of renal hypo assess precision of LZ eval for iliac dz endoleaks

Question 33

How to manage Type Ia?

Answer 33

compliant balloon if 5mm then consider aortic cuff palmaz (5cm at 10mm expansion 33mm at 28 mm)

Question 34

How to manage type Ib?

Answer 34

angioplasty | extension

Question 35

How to manage III?

Answer 35

angio | bridging stent

Question 36

How to manage renal artery coverage?

Answer 36

Pull caudally (wire over flow divider) Snorkerl (best from brachial) Bypass Open conversion

Question 37

How to manage CIA aneurysm?

Answer 37

Can extend into EIA Occlude the hypo Branched graft Bypass

Question 38

When to treat type II endoleaks?

Answer 38

evidence of type II with growth of 5mm

Question 39

what are treatment options for type II?

Answer 39

coil or glue embo transarterial (branch vessel, behind limb) translumbar transcaval laparascopic IMA clipping open surgical ligation conversion

Question 40

What are the landing zones of the arch?

Answer 40

``` 0 up to distal in nom 1up to distal LCA 2 up to distal scla 3 prox DTA 4 mid-distal DTA ```

Question 41

What are indications for spinal cord drainage?

Answer 41

``` prior AAA extensive coverage thoracic aorta coverage T8-L2 LSCLA without revasc dissection with malperfusion ```

Question 42

List indications for LSCA revasc.

Answer 42

``` patent LIMA bypass dominant l vert left vert with terminate PICA aortic arch origin of left vert hypo or stenotic right vert artery AVF in dialysis patient ```

Question 43

What are techniques for management of branches?

Answer 43

debranching parallel stents BEVAR, FEVAR Z-fen