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Procedures Fall 13 > Interventional Procedures > Flashcards

Interventional Procedures Flashcards

1
Q

What is the positive to interventional procedures?

A

Less invasive way to fix a problem

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2
Q

What are the 2 main reasons for vascular intervention?

A

Reduce or increase blood flow

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3
Q

What occurs to reduce blood flow?

A

Foreign substance, tissue or blood clot placed into the lumen of a selected vessel

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4
Q

What occurs to increase blood flow?

A

Percutaneous angioplasty via femoral or coronary arteries.

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5
Q

What are 6 ways to increase blood flow to arteries?

A
  1. Percutaeous transluminal angioplasty
  2. Primary stenting
  3. Directional coronary arthrectomy
  4. Percutaneous coronary rotational angioplasty
  5. Intravascular thrombolysis
  6. Infusion of vasodilators
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6
Q

What are different types of Vascular Interventional Angiopraghs?

A
  • Balloon angioplasty
  • Vascular stent
  • Thrombolysis
  • Embolization
  • Retrieval
  • Artherectomy
  • Vena Cava Filter Placement
  • Transjugular Interhepatic Potosystemic Shunt
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7
Q

What does TIPS stand for?

A

Transjugular Interhepatic Portosystemic Shunt

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8
Q

What occurs during a balloon angioplasty?

A
  • Enlarge a stenosis of a vessel lumen
  • Catheter used has 2 lumen one for guidewire and one for inflation/deflation
  • 20-40 seconds for inflation
  • Inflation with equal parts contrast and saline
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9
Q

What does the balloon pressing accomplish?

A

It presses the plaque into the vessel wall and is then withdrawn

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10
Q

What are some complications from angioplasties?

A
  • Tear in artery wall
  • Clot formation
  • Perforation
  • False aneurysm
  • Arteriovenous Fistula
  • Embolic showering
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11
Q

What is the purpose of a vascular stent?

A
  • Enlarge the lumen of a vessel
  • Provide support to hold vessel wall open
  • Used as a primary procedure
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12
Q

What are some complications of a stent placement?

A
  • Bleeding
  • Infection
  • Clot formation
  • Premature placement or misplacement of stent
  • Vessel Dissection
  • Crimping of stent
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13
Q

What occurs within the vessel with the balloon and stent?

A

The balloon is inflated and it expands the stent. The balloon is then deflated and removed while the stent remains within the vessel.

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14
Q

What is Thrombolysis?

A

Destruction or lyse of a clot or thrombus.

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15
Q

What is used to destroy a clot or thrombus?

A

Urokinase with heparin or a bolus injection at the site.

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16
Q

What are some complications from Thrombolysis?

A
  • Infection
  • Bleeding
  • Clot particles breaking off from vessel and blocking off a distal vessel
17
Q

What is an Embolization?

A

Forming a thrombus od blocks flow of blood in a vessel

18
Q

What substances are used in Embolization?

A
  • Dehydrated alcohol
  • Fibered coil
  • Boiling Contrast
    _ Glue
  • Gelfoam (squares that were in jar in class)
    -Occlusion Balloons
19
Q

What complications can occur from Embolizations?

A
  • Infections
  • Bleeding
  • Ichemia
  • Embolic agent at the intended site
  • Rupture of the vessel
  • Causing the clot to move
20
Q

What occurs during retrieval?

A

Removal of foreign objects from blood vessels

21
Q

What types of foreign objects are removed during Retrieval?

A

-Broken catheter or guidewire

22
Q

What can happen if a foreign object is not removed during Retrieval?

A
  • The object in venous flow will go to heart and lungs.
  • If it passes through the heart it could cause an arrythmia which can cause death
  • Arterial flow could cause other obstructions
23
Q

What devices are used for retrieval?

A
  • Balloon tip retrieval catheters
  • Goose-neck snares
  • Hook shaped catheters
  • Baskets
24
Q

What are complications from Retrieval?

A
  • Bleeding
  • Vessel Perforation
  • Thrombosis
  • Foreign body dislodges
25
Q

What occurs during a Transjugular Interhepatic Portosystemic Shunt?

A
  • The portal system is decompressed by shunting blood from the portal vein to the hepatic vein.
26
Q

What is used for a Transjugular Interhepatic Portosystemic Shunt>

A

expandable metal stent

27
Q

What are indications that the portal system is decompressed?

A

Variceal bleeding caused by hypertension, ascites, and primary cirrhosis

28
Q

What is the technique used for Transjugular Interhpatic Portosystemic Shunts?

A

Right jugular vein is cannulated and a guidewire, catheter, and needle are manipulated into the hepatic vein. This goes through the liver parenychema into the portal vein where a stent is placed between the portal vein and the hepatic vein.

29
Q

What are some complications from a Transjugular Interhepatic Portosystemic Shunt?

A
  • Intraperitoneal hemorrhage
  • Hepatic encephalopathy is a treatable side effect
  • Amonia levels increase
  • High mortality rate
30
Q

What occurs during an Arthrectomy?

A

Plaque is cut away from the vessel wall usually in the extremities where narrowed area doesnt remain open after angioplasty. A shunt may be used to keep the vessel open

31
Q

What are some complications from an Arthrectomy?

A
  • Cutting through a vessel wall
  • Clot formation
  • Large hematomas at the puncture site
32
Q

What does an arthrectomy catheter look like?

A

An egg beater/whisk

33
Q

What are some reasons for Nonvascular Intervention?

A
  • Percutaneous Methods (Modified Seldinger, Trocar Technique)
  • Nephrostomy
  • Percutaneous Biliary Drainage
  • Percutaneous Needle Biopsy
  • Gastrostomy Tube Placement
34
Q

What are some Nonvascular Interventional Procedures?

A
  • Needle Biopsy
  • Puncture and drainage
  • Percutaneoud calculi removal
    • kidney stone removed
    • non operative percutaneous calculi
    • Extracorporeal shock wave lithotripsy
    • Post op gallstones

Procedures Fall 13 (4 decks)

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