interventionalradiologyflash Flashcards
‘Most common arch anomaly ‘
‘Left arch with aberrant right subclavian artery. 2% of population.’
‘Two congenital aorta arch anomalies seen in an adult vascular radiology practice:’
‘Left-sided (normal) arch with aberrant right subclavian artery. Pseudocoarctation (aortic kink) of thoracic aorta.’
‘Diverticulum of Kommerell?’
‘Dilation at origin of aberrant right subclavian artery. May impress esophagus
‘Pseudocoarctation (aortic kink)?’
‘Mild form of coarctation
‘Traumatic aortic injury sites’
‘Proximal ascending aorta. Just beyond left subclavian (aortic isthmus). Just above the level of the diaphragm.’
‘Evidence of mediastinal hemorrhage includes’
‘Poorly defined fat planes. Mediastinal hemorrhage. Perivascular hematoma. Periaortic hematoma. Contrast extravasation.’
‘Direct signs of aortic injury include’
‘Abnormal contour of aorta. Change in caliber. Intraluminal irregularity (intimal flap).’
‘Keys to distinguishing a ductus bump from a contour abnormality at the aortic isthmus?’
‘Ductus bump is very smooth and convex without acute margins. Aortic tear has acute margins and irregularly shaped. May have associated Luminal narrowing. Persistence of contrast in the outpouching. Double densities. Intimal flap.’
‘Ascending aortic aneurysm causes:’
‘Cystic medial necrosis. Marfan syndrome. Ehlers-Danlos syndrome. Syphilis.’
‘Aneurysms of the arch and descending aorta
causes:’
‘Posttraumatic thoracic aortic aneurysms most often occur at’
‘Aortic isthmus.’
‘Major complications of thoracic aortic aneurysms’
‘Rupture. Acute dissection.’
‘Takayasu arteritis’
‘Granulomatous (giant cell) inflammation of media and adventitia of large elastic arteries. IAsian women. Female-to-male ratio of 10:1. Most often affects thoracic aorta and its proximal branches and pulmonary arteries.’
‘Aortic infection is usually divided into two types based on the causative microorganism:’
‘Syphilitic. Mycotic (nonsyphilitic).’
‘Mycotic nonsyphilitic aortitis
the most common organisms are:’
‘Very large aneurysmal aortic root with sinotubular ectasia (tulip bulb appearance)’
‘Marfan syndrome.’
‘Stanford classification for aortic dissection?’
‘Type A involves ascending aorta. Type B does not involve ascending aorta.’
‘Differential diagnosis of aortic dissection ‘
‘Intramural hematoma. Penetrating aortic ulcer. Together these constitute the acute aortic syndrome.’
‘Diagnosis of chronic PE by pulmonary angiography is based on the identification of’
‘Webs. Luminal irregularities. Abrupt vessel narrowing and/or obstruction. Dilated central pulmonary arteries.’
‘Most common complaint in symptomatic patients with PAVM’
‘Epistaxis from hereditary hemorrhagic telangiectasia.’
‘PAVMs categories’
‘Simple: One artery to one vein. Complex: Multiple feeding arteries and/or draining veins.’
‘Indications for transcatheter embolotherapy of PAVMs include’
‘Exercise intolerance. Prevention of neurologic complications. Prevention of lung hemorrhage (hemoptysis).’
‘PAVMs are usually treated when the feeding artery is at least’
‘3 mm in size.’
‘Most common indication for bronchial arteriography ‘
‘Hemoptysis.’
‘Common anatomic variants of peripheral arterial system. ‘
‘Absence of anterior or posterior tibial arteries (5% of individuals). High origin of radial artery from the axillary or brachial artery (17% of patients). Persistent sciatic artery (normal fetal branch of internal iliac artery that continues into lower etremity).’
‘In general
a normal ABI should be greater than’
‘An ABI between _____ and _____ signifies intermittent to severe claudication.’
’ 0.95 and 0.5 ‘
‘The angiographic appearance of diabetic vascular disease differs from typical atherosclerosis in two main ways:’
‘Vascular calcification involving arteries of all sizes. Disease involvement is more distal
‘Most common site for upper-extremity atherosclerotic involvement is the’
‘Proximal left subclavian artery. Can result in subclavian steal.’
‘In acute peripheral thrombosis or embolism
what clinical findings steer toward an endovascular approach versus open surgery.’
‘Exclusive of Takayasu arteritis
what two main vasculitides occur in the peripheral arterial system?’
‘Giant cell arteritis typically involves the’
‘Medium to large blood vessels supplying head (Temporal arteries)
‘Angiographic hallmark of Buerger disease is’
‘Corkscrew appearance of arteries. Collaterals around areas of occlusion (most often at wrists and ankles). Absence of atherosclerotic findings.’
‘Buerger disease (thromboangiitis obliterans)’
‘Acute inflammation and thrombosis of arteries and veins. Primarily affects hands and feet. Typically young heaving smoking males. ‘
‘Range of angiographic findings of trauma include’
‘Vasospasm. Intimal irregularity. Pseudoaneurysm. Extravasation. Arteriovenous fistula.’
‘Hypothenar hammer’
‘Repetitive palmar trauma. Injury of ulnar artery adjacent to hook of hamate. Ulnar artery can be aneurysm
‘Which peripheral arteries can be sacrificed (embolized) without consequence?’
‘Branches of internal iliac. Branches of profunda femoris. Geniculate branches. Subclavian/axillary/brachial artery branches (except vertebral). ‘
‘Fibromuscular disease (FMD) has been described in what arteries’
‘Upper extremity: Subclavian artery. Axillary artery. Brachial artery. Lower extremity: Iliac artery. Femoral artery. Popliteal artery. ‘
‘Thoracic outlet syndrome’
‘Compression syndrome of upper limb neurovascular bundle at the level of scalene muscles and first rib. 70% with arterial injury have a cervical rib.’
‘Popliteal entrapment’
‘Popliteal artery and or vein deviate around medial head of gastrocnemius.’
‘Adventitial cystic disease’
‘Mucin collects in adventitial layer. May lead to narrowing or obstruction. Most commonly in popliteal artery.’
‘Arteriomegaly’
‘Unusual manifestation of aneurysmal disease. Diffuse
‘Elective repair of an asymptomatic AAA is when the diameter exceeds’
‘5.0 cm.’
‘Endoleaks are categorized into four types:’
‘Type 1: Leak at superior or inferior attachment site. Type 2: Patent side branch filling grafted aneurysm sac (Lumbar or Inferior mesenteric artery). Type 3: Loss of stent graft integrity. Type 4: Leak through porous graft material.’
‘Commonest pathogen of mycotic aneurysms or pseudoaneurysms of abdominal aorta?’
‘Salmonella species
‘Leriche syndrome’
‘Bilateral buttock claudication
‘Aortoiliac occlusive disease can be caused by inflammatory diseases
in particular’
‘Hypoplastic aortic syndrome’
‘Congenital long segment narrowing of aorta. Usually seen in young females.’
‘There are a number of etiologies for renal artery occlusive disease
including’
‘Neurofibromatosis causes renal artery stenosis by’
‘Extrinsic compression of renal artery by neurofibromata. Disorganized intimal and medial proliferation at renal artery orifice or proximal renal artery.’
‘Hypertension secondary to neurofibromatosis is seen mainly in’
‘Children.’
‘Renal artery aneurysms
outside of trauma
‘PAN is a rare necrotizing vasculitis that affects small and medium-sized arteries of multiple organs
most commonly’
‘Differential diagnosis of microaneurysms includes’
‘PAN. Wegener granulomatosis. Systemic lupus erythematosus. Rheumatoid vasculitis. Drug abuse.’
‘most common aneurysm outside of aorta and iliac arteries.’
‘Splenic artery aneurysm.’
‘Hepatic neoplasms (mets included)
which are responsive to embolization?’
‘Tumor replacement of greater than _____% of normal liver is a contraindication to embolization.’
’ 50% to 75%.’
‘three collateral communications of mesenteric arteries.’
‘Marginal artery of Drummond: Anastomosis between right colic
‘Causes of acute mesenteric ischemia.’
‘Arterial embolism and thrombosis. Nonocclusive ischemia. Mesenteric venous thrombosis.’
‘A left SVC occurs in 0.3% of the population and descends through the left mediastinum anteriorly to join the _______
which drains into the RA’
‘Azygos continuation of the IVC is caused by’
‘Absence of intrahepatic portion of the IVC. Failure of right subcardinal vein to anastomose with hepatic veins. Hepatic veins drain into RA. Renal and iliac veins drain via azygos and hemiazygos veins into SVC.’
‘Retroaortic left renal vein
circumaortic left renal vein?’
‘The femoral vein is a continuation of the popliteal vein at the ______.’
‘Adductor hiatus’
‘Contraindications for peripheral thrombolysis: ‘
‘Internal bleeding. Stroke within past 6 months. Cranial or spinal surgery within past 2 months. Intracranial neoplasm. Bleeding diathesis. Uncontrolled hypertension. Contraindication to anticoagulation.’
‘Complications of venous thrombolysis include:’
‘Pulmonary embolus. Bleeding: At access site. Hemorrhagic stroke. GI bleeding. Retroperitoneal hematoma. ‘
‘Phlegmasia cerulea dolens’
‘Limb arterial compromise caused by massive acute venous thrombosis. Thrombosis involves both main and collateral venous drainage. Causes swelling and severe elevations in vascular resistance resulting in ischemia.’
‘Paget-von Schrötter syndrome’
‘Compression of subclavian vein by a cervical rib
‘SVC syndrome is caused by’
‘SVC stenosis and or thrombosis. Extrinsic compression: Bronchogenic carcinoma (up to 82%). Granulomas (histoplasmosis and tuberculosis). Lymphoma. Intrinsic: Intravascular foreign bodies (pacemaker leads
‘May-Thurner syndrome’
‘Compression of left iliac vein by crossing right iliac artery. This is normal anatomy. Arterial pressure on vein results in wall thickening
‘Budd-Chiari syndrome’
‘Occlusion of hepatic veins. Result of hepatic venous or IVC outflow obstruction.’
‘Coronary vein portosystemic shunt pathway’
‘Communicates with azygos system in submucosa of distal esophagus and gastric cardia.’
‘Contraindications to TIPS’
‘Hepatic failure. Severe right heart failure.’
