Brainscape's Knowledge GenomeTM

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


See full index

Personal CV > Endovascular Repair > Flashcards

Endovascular Repair Flashcards

1
Q

5 types of stenting procedures.

A
  • aortic
  • renal
  • distal vessels
  • carotids
  • cerebral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is EVAR, TEVAR, EVAAR?

A
  • endovascular aortic repair
  • Thoracic endovascular repair
  • Endovascualr abdominal aortic repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Prior to stent deployment, what is needed in the aorta?

A

-Landing zone of at least 1cm on both sides of graft.

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

What 2 things can happen with aortic branches?

A
  • Excluded by graft

- Aortic debranching (anatomic bypass)

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

Why did tube grafts have a high failure rate?

A

-Underestimation of atheromatous disease in the illiac or distal aorta

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

what problem arose with Aorto-uni-iliac stent grafts, and what did it necessitate?

A
  • Occlusion of the contralateral iliac

- fem-fem bypass

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

What does a modular bifurcated stent graft allow you to preserve?

A

Normal aorta-iliac anatomy

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

What is the benefit of a fenestrated stent?

A

-Accommodates visceral arteries

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

What does a branched stent graft allow for?

A

-Preservation vital arteries

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

When would a retroperitoneal approach be used?

A

-femoral vessels are small or heavily calcified

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

During a Retroperitoneal approach a conduit is sewn into what to introduce the graft?

A
  • Distal aorta

- Proximal iliac

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

What two things does a hybrid procedure combine? and when is it used?

A
  • Open surgical and endovascular stenting

- when major vessels would be occluded

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

Up 40% of TEVARS have lesions covering what? What does this require?

A
  • Ostium of the left subclavian

- Pre-TEVAR carotid-subclavian bypass

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

Describe stage 1 of a elephant trunk repair.

A
  • Open ascending aortc arch repair

- Leaving descending aneurysm alone

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

What is deep hypothermic circulatory arrest?

A

Find in reading

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

Describe stage 2 of an elephant repair.

A
  • Endovascular repair of the descending aorta

- Connecting to previously done open ascending repair

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

what is Aortic Visceral Debranching ?

A

Clarify

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When is elective repair appropriate for AAA?

A

-AAA > 5.0 cm or growing more the 1 cm per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is elective repair appropriate for TAA?

A

-TAA > 5.5 cm or growing more than 3 mm per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Repair is indicated for any ________ aneurysm.

A

Symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Indications for EVAR over open?

A
  • Significant co-morbidities

- Type B dissection

22
Q

Name the 2 types of aortic dissection classifications?

A
  • Debakey

- Standford

23
Q

Name the 2 types of stanford dissections?

A
  • A = Ascending or Ascending and descending

- B = Descending only

24
Q

Name the 3 Debakey types?

A
  • I = Ascending and Descending
  • II = Ascending
  • III = Descending
25
Q

EVAR MAC considerations?

A
  • Supine for 1-2 hours
  • Deep sedation not possible for need to hold breath
  • Favorable anatomy
  • Favorable aneurysm (no fenestrations or branch grafts)
26
Q

Central neuraxial blockade for EVAR?

A
  • No TEE, MEP or SSEP needed

- Be careful of heparin causing hematomas

27
Q

General anesthesia EVAR considerations.

A

-Used for: Illiac access, TEE, hemodynamic manipulations, SSEP/MEP, Difficult airway history

28
Q

What are the goals for anesthesia in EVAR?

A
  • Hemodynamic stability
  • Avoid HTN and tachycardia
  • Volume
  • Bleeding management
29
Q

Why avoid HTN and Tachycardia in EVAR?

A
  • Decrease coronary ischemia

- Reduce wall pressure in aorta

30
Q

EVAR renal considerations?

A
  • Hypoperfusion
  • graft occludes renal arteries
  • Emboli of renal arteries
  • Contrast induced neuropathy
31
Q

How to prevent renal injuries.

A
  • Adequate volume
  • Maintain BP and CO
  • Limit dye
32
Q

Pharmacologic strategies for baseline kidney disease.

A
  • Use Iso-osmolar or Non-ionic dyes
  • N-Acetylcysteine
  • Sodium Bicarb
  • Statins
33
Q

Causes of hypotension in EVAR

A
  • Iliac artery rupture
  • Accidental withdrawl leads to femoral bleed
  • Rupture of aortic aneurysm
  • Retroperitioneal bleed
34
Q

What can build up in lower extremities? And what can it lead to?

A
  • Lactic acid

- Lactic acidosis

35
Q

________ ________ can follow EVAR of acute aortic type _____ dissection.

A
  • Reperfusion syndrome

- B

36
Q

Guide wire manipulation can what? by stimulating what?

A
  • Arrhythmias

- Aortic baroreceptors

37
Q

Over advancement of guidewire can result in what?

A
  • Hemopericardium

- Cardiac tamponade

38
Q

What 3 maneuvers are used to create a motionless field?

A
  • Adenosine
  • Rapid ventricular pacing
  • Right atrial inflow occlusion
39
Q

How would you treat vasospasms

A

Nitroglycerin into major aortic branches

40
Q

Neurogenic hypotension can cause what? Leading to What?

A
  • Acute spinal artery syndrome

- Paraplegia and neurogenic shock

41
Q

Abdominal compartment syndrome may follow TEVAR for what?

A

-type B dissection

42
Q

Why would a CSF drain be used?

A

-To increase spinal cord perfusion pressure and prevent spinal cord ischemia

43
Q

what 2 ways can be used to increase spinal cord perfusion pressure?

A
  • Increase MAP

- Decrease CSF pressure

44
Q

What is the largest artery supplying the spine, and where does it originate?

A
  • Artery of adamkiewicz

- from aorta @ T9-T12

45
Q

Why would SSEP and MEP be utilized in EVAR?

A
  • Ensure spinal cord perfusion

- Identify ischemic changes

46
Q

When would TEE be used?

A
  • Elephant repair
  • Avoid contrast dye
  • Detect endo leaks
  • Aortic pathology
  • ID guidewire, sheath, endograft
47
Q

Occlusion of what 2 arteries can cause spinal cord ischemia?

A
  • Artery of adamkiewicz

- Critical intercostal

48
Q

What 4 things place one at a greater risk of spinal chord ischemia?

A
  • Previous AAA repair
  • External iliac injury
  • Hypotension r/t retroperitional bleed
  • Athersclerosis of thoracic aorta
49
Q

How do you treat parapelgia?

A
  • Increase MAP
  • CSF drainage
  • Repeated neuro exams
  • Avoid abrupt cessation of CSF drain
50
Q

What is the goal during graft deployment? What should be used?

A
  • Reduce blood flow through aorta.

- Esmolol, nipride, clevidpine

51
Q

Why is a motionless field so important after graft deployment?

A
  • Landing zones close to vessels

- Windsock effect

Personal CV (8 decks)

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