Chap 87-91 Open Endovascular Technique Flashcards

1
Q

List occlusive clamps.

A

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

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2
Q

List partially occluding clamps.

A

Lemole-strong aortic clamp
Statinsky
Cooley anastomosis

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3
Q

List self compressing clamps.

A

Potts bulldog
Debakey bulldog
Dietrich bulldog

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4
Q

List different needle types.

A
Calcific CC
Small BV
Medium C1
Large RB-1
Large aorta v7
Large MH
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5
Q

List when to use what size fogarty.

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

List adjunct to localizeing th eCFA for puncture.

A

palpation/landmarks
fluoro
US

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7
Q

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

A
18 gauge (0.035)
21 gauge (0.018)
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8
Q

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

A

900 PSI

300-500 PSI

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9
Q

List different flush catheters.

A

pigtail
omni
straight

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10
Q

List different single curved.

A

kumpe
Bernstein
MPA
MPB

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11
Q

List different double curved.

A
C1
C2
C3
head hunter
Rim
mammary
judkins
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12
Q

List diffferent reverse curve

A

SOS
VS1-3
simmons

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13
Q

Name different crossing catheters.

A

quick cross
trailblazer
crosscath
minnie

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14
Q

What is nominal pressure?

A

Pressure required to expand the balloon to stated diameter

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15
Q

What is rated burst pressure?

A

Pressure at which 99.9% of balloons tested will not burst

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16
Q

What is compliance?

A

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

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17
Q

Do lower compliance balloon have higher or lower burst P?

A

lower

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18
Q

What is trackability?

A

Ability to follow course of guide wire

19
Q

What is push ability?

A

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

20
Q
What size balloon for CIA?
EIA?
SFA?
pop?
tibial?
A
6-10
6-8
5-7
4-6
2-3
21
Q

List three devices used for crossing CTO?

A
corsser device (vibrate)
truepath (rotational)
frontrunner (articulating)
22
Q

What are pros for BE?

A

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

23
Q

What are cons for BE?

A

short lengths, prone to crushing

24
Q

What are pros for SE?

A

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

25
Q

What are cons for SE?

A

low radial force
less precise
limited radioopacity

26
Q

What are indications for secondary stenting?

A
Dissection
Residual stenosis
Pressure gradient
Occlusion
Recurrence
27
Q

What are indication for primary stenting?

A

Heavily calcified ostial lesions
Renal, mesenteric
Brachiocephalic
Aortic bifurcation

28
Q

What are relative indications for aorta-uni?

A

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

29
Q

What are some anatomical considerations for EVAR?

A
neck 10-15mm
neck diameter accomodate 10-20% oversize
angulation <20mm
iliac coverage 2cm
careful thrombus, conical, calcified, posterior bulges in neck
30
Q

what are relative CI for perch closure?

A
severly scarred groins
high fem bifurcation
frequen introducer changes
significant prox iliac occlusive disease
small ilio fem
anterior calcific femoral
31
Q

What are adjunct to facilitate contra limb cannulation?

A
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
32
Q

What to look for on completion angio?

A

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

33
Q

How to manage Type Ia?

A

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

34
Q

How to manage type Ib?

A

angioplasty

extension

35
Q

How to manage III?

A

angio

bridging stent

36
Q

How to manage renal artery coverage?

A

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

37
Q

How to manage CIA aneurysm?

A

Can extend into EIA
Occlude the hypo
Branched graft
Bypass

38
Q

When to treat type II endoleaks?

A

evidence of type II with growth of 5mm

39
Q

what are treatment options for type II?

A

coil or glue embo
transarterial (branch vessel, behind limb)
translumbar
transcaval

laparascopic IMA clipping

open surgical
ligation
conversion

40
Q

What are the landing zones of the arch?

A
0 up to distal in nom
1up to distal LCA
2 up to distal scla
3 prox DTA
4 mid-distal DTA
41
Q

What are indications for spinal cord drainage?

A
prior AAA
extensive coverage thoracic aorta
coverage T8-L2
LSCLA without revasc
dissection with malperfusion
42
Q

List indications for LSCA revasc.

A
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
43
Q

What are techniques for management of branches?

A

debranching
parallel stents
BEVAR, FEVAR
Z-fen