Interventional Flashcards
The majority of patients with a periprocedural stroke have an unfavorable neurologic outcome and, in one study, the in-hospital mortality was … percent
32
Fibrinolytic therapy is indicated if there is more than … minutes delay comparing the door-needle to door-balloon time.
60
Distal protection devices have been shown to be useful in … (type) SVG lesions PCI.
de-novo (not restenosed)
The antiscatter grid, which only allows perpendicular rays to pass, can be removed in … patients without compromising image quality.
children and very thin
… balloon has two chambers that inflate sequentially.
Inoue
Cine radiation dose is … times higher than the flouro.
10-15
The incidence of emergent CABG with PTCA is … %
2
Final patency is greater with SVG lesions located …
distally.
Fibrinolytic therapy is indicated if there is more than … minutes delay to PTCA.
90
As opposed to fibrinolytic therapy, patients with PTCA have lower … rates.
mortality and reinfarction
As opposed to fibrinolytic therapy, patients with PTCA have higher … (complication) rates.
bleeding
In asymptomatic patients, significant proximal LAD lesions benefit from …
revascularization.
2-3 months after unprotected LM stenting, … is recommended.
routine angiographic survey
In patients with high risk for stent thrombosis, if platelet aggregation studies show less than… , clopidogrel dose should be 150mg daily.
50% inhibition (class IIb)
In patients who do not receive 2b3a for PTCA, target ACT should be … with Hemotech device.
250-300
In patients who do not receive 2b3a for PTCA, target ACT should be … with Hemochron device.
300-350
In patients who do receive 2b3a for PTCA, target ACT should be … with Hemotech or Hemochron device.
200
According to TIMI-11B, using LMWH instead of heparin decreased death and non-fatal MI at 43 days by …%
17
Abciximab dose needs adjustment for RF (true/false… ).
false, it is removed by the reticuloendothelial system
Bivalirudin half life is …
20-25 minutes.
A study from Catheterization and Cardiovascular Interventions from 02/02, demonstrated on 66 patients that the radial approach to coronary angiography is safe and to be recommended in the fully anticoagulated (INR… ) patient.
> 2 but
Upstream 2b3a in ACS decrease the risk for …
death, MI and unplanned revascularization.
Upstream 2b3a in ACS increase the risk for …
major bleeding
NSTEMI non-PCI candidate or non-invasive therapy arm should be started immediately on … as part of their antithrombotic/antiplatelet regimen.
clopidogrel
When receiving thrombolytic therapy for STEMI, … should be a part of their antithrombotic/antiplatelet regimen.
75mg clopidogrel
In order to assess the effects of thrombolytic therapy a waiting time of … should be used.
60-90 minutes
Both paclitaxel and sirolimus work by inhibiting the cell cycle at …
G1-S step.
The … technique is used when stenting an ostial branch lesion with a balloon inflated at low pressure in the main vessel and the branch stent pulled back against it.
stent-pull-back
In a normal endothelium, acetylcholine or methergine cause…
vasodilation.
Cipher stents are made on the BxVelocity platform and the struts can be dilated… diameter for side branches.
up to 3mm
A concentric narrowing of the distal epicardial vessel is typical for …
transplant vasculopathy.
Taxus stents are made on the Express platform with … cell design
open
Calcified ostial lesions are best treated with the…
rotablator.
Iodixanol (Visipaque™) is a nonionic, … osmolar contrast agent.
iso
Post catheter based ASD closure, … (test) should be done next day.
an echo to exclude erosion leading to tamponade or device migration
A patient with normal renal function who did not stop metformin 48h prior to elective PCI, one should…
proceed with the intervention.
Taxus stents are made on the Express platform and the struts can be dilated… diameter for side branches.
more than 3mm
ACC/AHA classification uses the term “…” for lesions that are less than 10mm long.
discrete
ACC/AHA classification denotes … the lesions that are more than 20mm long.
long
By convention, the … is the ratio between the late loss and the acute gain.
loss index
Bradycardia which commonly occurs during coronary angiography, most often at the end of the injection of ionic contrast into the right coronary artery;… (maneuver) helps to clear the contrast, support perfusion, and restore normal cardiac rhythm.
forceful coughing
Patients with postrevascularization recurrent symptomatic ischemia within… mo of percutaneous revascularization is class IIa indication for coronary angiography.
12
If a severe reaction to the contrast agent does occur, it can be reversed by using…
boluses of 1ml/min IV epinephrine (1:10,000 epinephrine diluted to 10 mL) until the arterial pressure is restored.
… is generally heralded by bradycardia and hypotension due to vagal stimulation induced by blood in the pericardium; if the patient is hemodynamically stable, echocardiography is suggested to document the presence of blood in the pericardial space.
Cardiac perforation
Vasovagal reactions, which can include bradycardia, hypotension, yawning, and/or sweating, can be seen in up to 3 percent of patients during coronary angiography; treatment usually consists of volume administration, …, and removal of the painful stimulu
atropine 0.5 to 1.0 mg intravenously
In patients on heparin anticoagulation undergoing coronary angiography, the heparin is either allowed to wear-off over the following… hours prior to sheath removal, or the sheath is removed in the fully anticoagulated state using an arterial closure dev
two to three
When a pseudoaneurysm is identified at the catheter insertion site, surgical repair is generally recommended if the size is greater than… cm or an expanding hematoma is noted.
2
Prophylactic placement of a temporary pacemaker during coronary angiography is … in patients with bundle branch block or intervention in the right coronary artery.
not necessary
… should be performed in the presence of hemodynamic instability after cardiac perforation.
Emergent pericardiocentesis via the subxiphoid approach
The only absolute contraindication to balloon angioplasty is…
a lesion with less than 50% luminal narrowing.
This post-ACS intervention (non-drug) decreases death and all-cause mortality in 20-25% of patients…
cardiac rehab.
… trial compared sirolimus-coated stents with bare stents and found almost complete annihilation of in-stent neointimal hyperplasia and an impressive reduction in the subsequent associated clinical events at 6 months.
RAVEL
The CASS trial showed a significant 7-year survival benefit in the group treated by… in three-vessel disease with 35%<50%.
surgery
Late subacute stent thrombosis occurs at … months after PCI.
1-12
… is the administration of thrombolytics to speed up reperfusion prior to PCI.
Facilitated angioplasty
The definitive therapy in right ventricular infarction is…
revascularization.
An IV bolus of… 1h before PCI followed by 24h infusion will give a relative reduction in the procedure-related AMI of at least 50%.
abciximab (Reopro)
There is no benefit in giving… in patients with ACS when no PCI is planned.
abciximab (Reopro)
The posteromedial papillary muscle receives blood supply from the… only.
PDA
In patients with papillary muscle rupture, the culprit is… in 70% and… (coronary artery) in 30% of cases.
RCA / LCX
… trial showed a 31% reduction in CV death or recurrent AMI in post-AMI patients undergoing PCI and treated with clopidogrel vs. placebo.
PCI-CURE
… following a large contrast exposure is due to osmolar disruption of the blood-brain barrier.
Acute cortical blindness (10/23/2008)
Ticlopidine and clopidogrel cannot be recommended in stable angina due to a very low risk of… (2 conditions).
leucopenia and TTP.
The catheter-induced spasm is more common in the… coronary artery.
proximal right
… occlusion leads to STE in leads I and aVL.
Diagonal
… leads to STE in V1-3, II, III and aVF.
“Wrap-around” LAD occlusion or proximal RCA
Marked STD in V1-3 may indicate a… AMI that should be handled and treated as STEMI.
true posterior
… occlusion causes extensive ST depression in the anterior chest leads +/- some STE in the lateral leads.
Left circumflex
The amount by which the coronary blood flow increases in response to maximal arteriolar dilatation is defined as the… and reflects the vasodilator capacity of the heart.
coronary flow reserve
… (coronary) occlusion causes a pattern of diffuse subendocardial ischemia with extensive ST depression.
Left main
STE in aVR in patients with inferior AMI should prompt a clinical and ECG search for…
right ventricular infarction.
… leads to STE in V1-3, and STD in II, III and aVF.
“Non-wrap-around” LAD occlusion
Very widespread STD (7 or more leads) is highly specific for…
AMI.
… in the jugular venous pulse (sign) results from the inability of the RA to empty during diastole in cardiac tamponade.
Loss of the normal y-descent
Myocardial bridging is easier to recognize in the … (angiographic view).
left anterior oblique than right anterior oblique projections.
Hemodynamic monitoring can help construct a… curve at the bedside, identifying the filling pressure at which the cardiac output is maximal.
Starling ventricular function
… has been instrumental in determining the success of interventions such as stent deployment in coronary artery disease.
Intracoronary ultrasonography
It is usually not recommended to enter the LV across a mechanical aortic valve, so… is used.
the transseptal technique
… is the route used for balloon dilatation of mitral stenosis.
The transseptal technique
In patients with a pulmonary artery catheter, pulmonary capillary wedge pressures (PCWP) of… are recommended for cardiogenic shock.
18 to 24 mmHg
In patients with a pulmonary artery catheter, pulmonary capillary wedge pressures (PCWP) of… are recommended for septic or hypovolemic shock.
12 to 14 mmHg
This support measure… is indicated for patients with angina refractory to Rx, cardiogenic shock, or mechanical complications of AMI (including severe MR, VSD) or for those who have severe LM stenosis and will be undergoing cardiac Sx.
Intraaortic balloon pump (IABP) insertion
The mortality risk from cardiac catheterization is less than …
0.1 percent.
Left ventriculography is performed in the 30-degree right anterior oblique and … -degree left anterior oblique views.
45- to 50
If blood flow is not restored after an AMI, actual tissue loss occurs, and there is replacement by fibrous tissue and a scar forms in approximately … (time).
6 weeks
Patients with diabetes receiving metformin should have the medication discontinued the morning of the procedure and not restarted until the creatinine is stable at least … hours after the procedure.
48
The risk of a major complication from cardiac catheterization is less than …
2 percent.
The precatheterization prothrombin time international normalized ratio should be less than … to avoid increased risk of bleeding.
1.8
Sheath removal is usually not recommended until the activated clotting time is less than … seconds unless a vascular closure device is being utilized.
175
The most common procedure-related complication necessitating hospitalization after cardiac catheterization is …
hematoma.
The maximum allowable whole-body radiation dose per year for those working with radiation is … roentgen-equivalent-man (rem).
5
Left ventriculography is performed in the … -degree right anterior oblique and 45- to 50-degree left anterior oblique views.
30
Power injection of … ml of contrast medium into the ventricle is used to assess left ventricular function and the severity of mitral regurgitation.
30 to 40
After coronary arteriography and left-heart catheterization have been completed, the catheters are removed and firm pressure is applied to the femoral area for … minutes, either by hand or by a mechanical clamp.
15 to 20
The patient should be instructed to lie in bed for … hours after angiography with 4 or 5F catheters, with the leg remaining straight to prevent hematoma formation.
2
The patient should be instructed to lie in bed for … hours after angiography with 6F catheters, with the leg remaining straight to prevent hematoma formation.
3 to 4
One systematic review has found that primary percutaneous transluminal coronary angioplasty when compared with thrombolysis…
reduces a combined outcome of death, non-fatal reinfarction, and stroke.
Two RCTs in people with acute myocardial infarction (after thrombolysis was introduced) found… between nitrates and placebo.
no significant difference in mortality
Longer-term follow-up results of the PROTECT-AF trial demonstrate?
the superiority of device closure compared with warfarin anticoagulation in patients with nonvalvular atrial fibrillation (NVAF).
This study confirms the high incidence of MI in patients with CAP and shows that … is a potential explanation for the acute Mis
an increase in platelet activation in CAP
Longer-term follow-up results of the PROTECT-AF trial demonstrate…
the superiority of device closure compared with warfarin anticoagulation in patients with nonvalvular atrial fibrillation (NVAF).
This study confirms the high incidence of MI in patients with CAP and shows that … is a potential explanation for the acute Mis
an increase in platelet activation in CAP
