Diagnostic Modalities & Treatment Flashcards
Gold standard for pre-operative assessment of patients for carotid intervention
Arteriography
Method of choice for visualizing entire cerebral arterial system
Digital subtraction (DS) angiography
T/F MRA is less reliable than duplex Doppler for categorizing stenosis in areas of mod-severe narrowing
True
MRA is least preferred
What is the technique for mechanically widening narrowed/obstructed arteries using a balloon + guide wire
Angioplasty
Non-invasive diagnostic techniques (3)
MRA
Duplex & TCD combined
CT
What is expected post-stent insertion? (3)
Increase velocity (PSV up to 150 cm/s)
Disturbed flow
Gradual increase in PSV expected - abrupt is ABNOORMAL
What is recommended as the FIRST LINE of treatment? What is the criteria?
Carotid endarectomy
Symptoms + stenosis >50%
Asymptomatic + stenosis >60%
T/F carotid angioplasty (CAS) is not recommended for patients for NO SYMPTOMS
True
When is carotid angioplasty indicated?
Symptoms + >50% stenosis and CEA is high risk for anatomical/medical reasons
Complications associated with CEA (8)
Residual plaque at the end of the CEA site Intimate flap Dissection Occlusion Infected patch Hematoma Pseudo aneurysm Restenosis
Coarctation is most common in the
Aortic arch - where the ductus arteriosus inserts
What is COARCTATION (CoA or COAo)
Narrowing
How do you detect coarctation?
A difference of >70mmHg between brachial and ankle systolic pressures at rest
Why might patients with coarctation not have claudication (pain with walking) and no change in ankle pressure after exercise
Due to the development of extensive collateralization that provides compensatory flow to the exercising muscles of the lower limbs
Repair of coarctation (2)
Resection with end to end anastomosis
Angioplasty
