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Rad Pro 3 > Interventional radiography-Part 2 > Flashcards

Interventional radiography-Part 2 Flashcards

1
Q

Read over the following interventional proceedures

A

Angioplasty (PTA)
Embolization
IVC filter placement
TIPS
Extraction of foreign bodies
Biopsies
RF Ablations
Central Venous Catheter placement
Angiography
Vertebroplasty/Kyphoplasty

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2
Q

What scan is shown here?

A

Lower Extremity Arteriography-CT run off

-Show all the vessels to see if there is any stenosis

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3
Q

What scan is shown here?

A

Upper Extremity Arteriography

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4
Q

What treatment is shown here?

A

Rotational thoracotomy

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5
Q

What areas of the body is Arteriography done for?

A

The Upper Extremity and Lower Extremities

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6
Q

What are the indications for arteriography?

A

-Atherosclerotic disease, stenosis, occlusion, trauma
-Embolus or Thrombus (DVT)
-Identify vessels for arterial bypass grafting
-Pre/Post bypass surgery

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7
Q

What is Claudication?

A

Decreased blood flow to the veins in the lower E.

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8
Q

What are the treatments for claudication?

A

-Angioplasty
-Stenting

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9
Q

What treatment is done for an embolus or Thrombus (DVT) ?

A

Thrombectomy (removal) or Thrombolysis

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10
Q

In the TIPS procedure, what are they going through after the internal jugular vein to get to the hepatic vein?

A

The brachiocephalic vein, SVC, through the heart (RA) into the IVC and then the hepatic vein

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11
Q

What are the two types of Thrombectomy procedures?

A

1.Mechanical removal of clot with special retrieval stents
2.Rotational atherectomy

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12
Q

What is a rotational atherectomy?

A

Special device that rotates 160,000 to 200,000 RPM in which pulverized plaque (size of blood cell) is removed by reticuloendothelial system

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13
Q

When is rotational atherectomy most effective?

A

Very effective when the plaque is heavily calcified

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14
Q

When we have plaque in the coronary arteries, when would we do thrombectomy over balloon angioplasty?

A

If the plaque is very calcified

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15
Q

What is thrombolysis?

A

Dissolving the clot using medication
(TPA)

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16
Q

What is an AV fistula?

A

AV fistula is the gold standard for access for dialysis

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17
Q

Who creates an AV fistula?

A

-Created by vascular surgeon

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18
Q

What happens if stenosis (especially with grafts) occurs following the creation of an AV fistula?

A

Interventional Radiologist performs PTA

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19
Q

T/F

Fistulas take time to mature

A

True

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20
Q

Why is an AV fistula the gold standard for dialysis?

A

Vein gets bigger because of pressure and wall gets stronger (able to withstand multiple needle pokes)

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21
Q

What does the distal & proximal wires in dialysis take in?

A

-The more distal one takes the blood to dialysis
-The more proximal takes the clean blood in

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22
Q

What is shown here?

A

Upper Extremity Arteriography - Fistula

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23
Q

What is shown here?

A

Upper Extremity Arteriography - Fistula

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24
Q

What artifact is shown here?

A

IVC Filter

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25
Q

What are the two main methods for biospies?

A

Core biopsy
Fine Needle Aspiration

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26
Q

What needle is this?

A

A core biospy needle

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27
Q

What method of biospy is this showing?

A

Fine needle aspiration

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28
Q

What treatment is this showing?

A

RF ablation

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29
Q

What treatment is this showing?

A

RF ablations

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30
Q

What gauge is used for a core biopsy needle; large or small gauge?

A

Large gauge needle

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31
Q

T/F

A core biopsy needle is hollow

A

True

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32
Q

How is tissue removed with a core biopsy needle?

A

A “plug” of tissue removed for analysis by using either a spring-loaded gun or suction to get the sample

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33
Q

What type of analysis is core biopsy used for?

A

Histologic analysis

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34
Q

What are the risks of core biopsies?

A

Greater risks (hemorrhage, sepsis, and tumor seeding)

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35
Q

What biopsy method is more accurate?

A

Core biopsy

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36
Q

What type of analysis is fine Needle Aspiration used for?

A

-Cytologic analysis only

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37
Q

T/F

With fine needle aspiration, a smaller needle is attached to a syringe to acquire cell samples

A

True

38
Q

What modalities are used for guidance during biopsies?

A

-Fluoroscopy
-Ultrasound
-CT
-Combination of these

39
Q

What modality is used to reduce the complication rates during a guided biopsy?

A

CT and U/S used in conjunction with fluoro reduce the complication rates

40
Q

How is the modality for guided biopsies chosen?

A

By the physician’s preference, equipment available, patient condition, and organ location

41
Q

What is this describing?:

High frequency current heats tissue and causes cell death in tumours by using coagulation necrosis

A

RF ablations

42
Q

Why is image guidance needed for RF ablations? What modalities are used?

A

-Image guidance is required to get the needle electrode into position
-Ultrasound, CT, and MRI commonly used for image guidance

43
Q

For an RF ablation that is at 50° - 52° C, how long does it take for the ablation to complete?

A

4-6 minutes

44
Q

For an RF ablation that is at >60° C, how long does it take for the ablation to complete?

A

Instantaneous

45
Q

T/F

Active tip of an RF ablation needle can be different lengths and configurations

A

True

46
Q

What is Necrotic tissue replaced by in RF ablations?

A

Fibrosis and scar tissue

47
Q

What can RF ablations be used to treat?

A

1.Tumours
2.Cardiology issues
3.Pain Management
4.Control Bleeding

48
Q

What type of tumours does RF ablations treat?

A

Primary or metastatic tumours in the liver, lung, kidney, pancreas, bone, prostate, breast, lymph nodes

49
Q

What size of tumour does RF ablations treat?

A

Small (should be < 3 cm, otherwise inoperable tumours, can be destroyed)

50
Q

How does RF ablation treat cardiology issues?

A

It destroys abnormal electrical pathways that lead to arrhythmias

51
Q

What cardiology pathologies does RF ablations treat?

A

Atrial flutter, atrial tachycardia, atrial fibrillation

52
Q

What treatment is shown here?

A

Rhizotomy-RF ablations

53
Q

What CVC is this showing?

A

Dialysis catheter or (PermCath or Raaf)

54
Q

What CVC is this showing?

A

Dialysis catheter or (PermCath or Raaf)

55
Q

What CVC is this showing?

A

Left: Hickman
Right: Broshong

56
Q

What is the difference between a hickman and a broshong?

A

Hickman has clamps

57
Q

What CVC is this showing?

A

Hickman

58
Q

What CVC is this showing?

A

PICC

59
Q

What vein does a CVC start at?

A

The basillic vein in the arm

60
Q

What is Rhizotomy?

A

Nerves around facet joints of lumbar spine are ablated for pain management

61
Q

What drug confirms the nerves causing the back pain prior to the ablation?

A

Lidocaine (local anaesthetic)

62
Q

How do RF ablations work for pain management?

A

Damaged nerves prevent pain signals to be sent to the brain

63
Q

T/F

Rhizotomy is temporary

A

True…nerves regenerate in time

64
Q

How long does pain relief from a rhizotomy typically last?

A

6 – 24 months

65
Q

When are RF ablations used to Control Bleeding?

A

-Prior to tumour resections
-As the electrode is withdrawn from a vascular area

66
Q

What doctor inserts CVCs? (Central venous catheters)

A

Interventional Radiologist

67
Q

What are the 3 types of central venous catheters?

A

-Dialysis catheter or (PermCath or Raaf)
-Hickman or Groshong
-PICC (insertion or adjustment)

68
Q

What is a dialysis catheter used for?

A

Shorter term dialysis treatment

69
Q

What are Hickman or Groshong catheters used for?

A

-Long term antibiotics, chemo, TPN (total prenatal nutrition)

70
Q

What are PICCs used for?

A

Often for antibiotics (infected joint replacement)-Shorter term

71
Q

Why do they tunnel under the skin when inserting a dialysis catheter into the subclavian vein?

A

It decreases the rate of infection, you can’t pull it out as easy when you are going through the skin (gives stability)

72
Q

What tube is shown here?

A

Pigtail-Abscess Drainage Tube

73
Q

What tube is shown here?

A

Pigtail-Abscess Drainage Tube

74
Q

What tube is shown here?

A

Percutaneous Nephrostomy Tube

75
Q

What type of tube is shown here?

A

Gastojejunal tube

76
Q

What treatment is shown here?

A

Vertebroplasty

77
Q

What tretment is shown here?

A

Vertebroplasty

78
Q

What is the purpose of an Abscess Drainage Tube

A

Draining of Infected collection of fluid

79
Q

What modalities are used for guidance of the placement of an abscess drainage tube?

A

CT, US, fluoro used to place tube

80
Q

Where can abscess drainage tubes be placed in the body?

A

Chest, pelvis, abdomen

81
Q

When is a Percutaneous Nephrostomy Tube used?

A

-When doctors cannot place a ureteral stent in the kidneys
-Prostate cancer (where they can’t get a stent in)
-bladder cancer

82
Q

What type of patients usually need a GJ tube?

A

Stroke patients, esophageal or oral cancer patients

83
Q

What is this describing?

It is an image-guided, minimally invasive, non-surgical therapy used to strengthen a vertebral body with a compression #

A

Vertebroplasty or kyphoplasty

84
Q

What substance is injected into the vertebral body during a Vertebroplasty? Why?

A

Percutaneous injection of acrylic cement into vertebral body for stabilization and pain relief

85
Q

What modality is used for guidance with a vertebroplasty?

A

Often a combination of fluoro and CT is used (c-arm in CT)

86
Q

T/F

Vertebroplasty can only be used for patients with severe compression fractures.

A

False; For someone with a minimal compression fracture

87
Q

What treatment is this showing?

A

Kyphoplasty

88
Q

What is Kyphoplasty?

A

When a balloon is used to actively restore vertebral height, and then the cavity that is formed is filled with cement

89
Q

T/F

Vertebroplasty is a minimally invasive procedure that can alleviate up to 90% of pain caused by compression #’s

A

False; this is for kyphoplasty

90
Q

T/F

Kyphoplasty Can also stabilize the #, restore height & reduce deformity

A

True

91
Q

What are the benefits of kyphoplasty and vertebroplasty?

A

-Short surgical time
-Average hospital stay is one day (or less)
-Patients can quickly return to normal activities
-No bracing required

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