Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CV2 Constable > Endovascular Cases > Flashcards

Endovascular Cases Flashcards

1
Q

What is a Debakey Type III?

A

Aortic dissection at the descending aorta only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a Debakey Type I?

A

Aortic dissection including both ascending and descending aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a Debakey Type II?

A

Aortic dissection involving only the ascending aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a Stanford A?

A

Aortic dissection involving the ascending aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a Stanford B?

A

Aortic dissection involving the descending aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is EVAR?

A

Endovascular Aortic Repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is EVAAR?

A

Endovascular Abdominal Aortic Repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is TEVAR?

A

Thoracic Endovascular Aortic Repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How much landing zone is needed for an aortic stent/graft to be placed?

A

1cm above and below

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why would the retroperitoneal approach be used?

A

If femoral vessels are small or heavily calcified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which abd aortic pathologies are able to be endovascularly? Which Surgically?

A

Type A, B, C=endovascular

Type D, E=Surgical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Over 40% of TEVAR candidates have lesions covering which arterial branch?

A

Ostium of left subclavian artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What must be done with a TEVAR candidate that has their left subclavian artery covered by the lesion?

A

Left Carotid-Subclavian Bypass procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which procedure is completed first in a staged elephant trunk repair?

A

Stage 1= Total arch surgical replacement

Stage 2= Endovascular repair using trunk graft as proximal landing zone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which Stage (1 or 2) of the Staged Elephant Trunk Procedure requires deep hypothermic circulatory arrest?

A

Stage 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are indications for and elective repair of an AAA?

A

Greater than 5.0cm or growing by more than 1 cm/year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are indications for symptomatic aneurysms repair?

A

Repair all

18
Q

What are indications for elective repair of a TAA?

A

Greater than 5.5cm or growing greater than 3mm/year

19
Q

Can EVARs be done under MAC/sedation?

A

Patient must be able to lay supine for 1-2hrs without deep sedation d/t patient needing to hold breath for imaging

20
Q

Other than general contraindications to neuraxial blockade, what specific contraindications are there for epidurals/spinals for EVAR?

A
  1. No need for TEE
  2. No need for MEP or SSEPs
  3. No need for COMPLETE motionless field during stent deployment.
21
Q

What specific patients may be great candidates for central neuraxial blockade versus GETA?

A

Patients with terrible lung disease that may have issues coming off ventilator

22
Q

What are 5 reasons to choose GETA for EVAR case?

A
  1. Complicated- fenestrated or branched endografts
  2. Planned use of TEE
  3. Planned hemodynamic manipulations to create motionless field
  4. Planned SSEP or MEP monitoring
  5. History of difficult airway.
23
Q

Is EVAR considered high-risk surgery?

A

Yes; Patients should undergo functional testing consistent with ACC/AHA guidelines.

24
Q

What is the biggest risk during planned or unplanned hemodynamic manipulations with EVAR?

A

Acute Kidney Injury

25
Q

What are 4 reasons for AKI in EVAR cases?

A
  1. Hypoperfusion/hypotension
  2. Mechanical encroachment of stent graft on renal vessels
  3. Emboli to the renal arteries
  4. Contrast induced nephropathy
26
Q

How often does contrast induced nephropathy occur?

A

2-10% of patients

27
Q

What are four methods of reducing risk of AKI?

A
  1. Ensure perioperative euvolemia
  2. Maintain CO and BP
  3. Limit contrast dye
  4. Use Iso-osmolar/non ionic contrast dye
28
Q

What 3 medications can be used with patients that have baseline kidney disease?

A
  1. N-Acetylcysteine
  2. Sodium Bicarbonate
  3. Statin Drugs
    (also steroids)
29
Q

What are 4 major causes of intra-operative hypotension/blood loss?

A
  1. Iliac artery rupture
  2. Accidental withdrawal of device
  3. Rupture of the aortic aneurysm
  4. Retroperitoneal bleeding
30
Q

Why might an EVAR patient have a lactic acidosis?

A
  1. Secondary to reperfusion of lower extremities following decreased flow from cannulation
31
Q

Why might the anesthesia provider be asked to induce Vfib?

A

To limit ejection and heart to remain still for valve deployment in TAVRs and work close to the aortic valve.

32
Q

What pharmacologic treatment may the surgeon administer to treat vasospasm?

A

Nitroglycerin

33
Q

How do you calculate Spinal Cord Perfusion Pressure (SCPP)?

A

SCPP= MAP - CSF Pressure

34
Q

T/F: As CSF drainage increases through SA drain, SCPP will go down?

A

False; draining more CSF will decrease CSF pressure and therefore increase SCPP

35
Q

What is the largest arterial blood supply to the spinal cord?

A

Artery of Adamkiewicz

36
Q

Where does the Artery of Adamkiewicz arise from the aorta?

A

Typically T9-T12 (can arise from T5-L5).

37
Q

Managemant of Paraplegia following TEVAR?

A
  1. Elevation of MAP >80mmHg
  2. Therapeutic CSF drainage
  3. Repeated neuro exam
  4. Avoid abrupt cessation of CSF drainage
38
Q

What is post-implantation syndrome?

A

Early in the post-op period characterized by fever, leukocytosis, elevation of inflammatory mediators (CRP)

39
Q

Describe the 5 endoleaks:

A 
Type I: Leaking around graft
Type II: Retrograde flow from other vessles
Type III: Rupture or Mis-aligned 
Type IV: Pressure in graft
Type V: Leaking through graft
40
Q

T/F: Most trials show no benefit with EVAR compared to open in the short term; but long term EVAR is better?

A

False; Benefits in short term with EVAR, but by one year, they are equal

41
Q

What did the DREAM trial show?

A

Dutch Randomized Endovascular Aneurysm Management trial showed 30 day mortality rate 1.2% EVAR and 4.6% Open
More equal after one year

42
Q

What plays a huge role in why EVAR cases may do better inititally?

A

Patient selection is major factor

CV2 Constable (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions