Chapter 15 Flashcards
what is an arteriography?
percutaneous puncture of superficial artery; insertion of thin catheter
which arteries are used for arteriography?
CFA (safest approach), axillary, brachial
how does the arteriography work?
after proper positioning, contrast agent injected into catheter, flows with moving blood, gives picture of lumen
rapid film changer technq used to expose the films sequentiallly as contrast agent moves through vessel
using fluoroscopy, digital info obtained/stored for later manipulation/ interpretation
what is the recovery for arteriography?
catheter removed, pressure held on puncture site; patient supine for 6-8 hours. sandbag placed on top of dressing to help avoid bleeding
T/F arteriography is a anatomic study not a functional study
true
how is a significant stenosis usually defined by an arteriography
50% diameter reduction
what is the interpreation of an arteriography?
based on how much (if any) of artery doesnt fill with blood containing contrast agent. extent and location of filling defect is determined
how does atherosclerotic plaque appear on arteriogrpahy
irregular or smooth
what will vessel occlusion look like on arteriography?
no filliing seen. collateral often present with long standing occlustion
what will a vasospasm look like on an arteriogrpahy?
severe narrrowing usually without occlusion
what will a aneursym appear on arteriography?
dilated artery
what will a fibromuscular dysplasia look like on arteriogrpahy?
multiple arterial stenosis caused by medial hyperplasia appearing as string of beads
what are limitations of arteriography?
may be contrasindicated in patients allergic to contrast agent or in kindey failure
inaccurate in it hemodynamic asssessmet bc of inability to provide many images in multiple planes in real time 2D is standard
what are complications of arteriogrpahy?
puncture site hematoma
pseudoany
local arterial occlusion
neurologic complications
what is the method for MR angiography (MRA)
employs radio freq energy and a strong magnetic field to produce images in multi planes
MRI instruments quantitate blood flow and construct images that look like angiogrpahym (MRA). flowing blood well distinguished from soft tissue without contrast agents
what are MRA limiation?
presence of metallic clips, pacemakers, monitoring equipment
can overestimate stenosis due to flow flow or turbulence
expensive
claustrophobia may limit some patients
what is interpretaton of MRA?
useful for AAA, dissections, peripheral artery evaluation
what is CT method?
employs ionizing radiation to obtain cross sectional images of the aorta and other body structures
IV contrast allows more discrete evaluation
what are CT limitations?
patient motion and presence of metal surgical clips
one plane used
limited application in PAD due to smaller vessels
what is CT interpretation?
identifies size of aorta, extent and size of aneurysm
helps define relatipship of aorta to renal artery origins
what are lifestyle modifications?
stop smoking
consistent exercise to enhance collateral developement
weight controle and a low cholesterold diet may enhance normal endothelial cell metabolism
protection to prevent injury and or infection to extremity of interest
what are pharmacologic methods of treatment?
aspirin: an antiplatelet drug that decreases platelet aggregation resulting in decreased thrombotic activity
medications that help decrease blood viscosity
antihypertensive drugs may serve to decrease shearing forces against vessel walls
what are some examples of antihypertensive drugs?
ACE ARB beta blockers diurectics HTN meds
what is endarterectomy?
surgical removal of atherosclerotic material usually includes portion of intimal lining
