IR: Thoracic Flashcards
GCA is what type of vasculitis? age? vessels?
medium and large vessel vasculitis; similar to Takayasu
affects older patients
usually upper extremities (subclavian, axillary, brachial)
diagnosis of GCA and treatment?
temporal artery biopsy and steroids
left anterior cardinal vein persistence
left sided SVC
-embryologic left anterior cardinal vein usually regresses
right anterior cardinal vein develops into?
SVC
duplicated SVC cause
persistent R/L anterior cardinal vein
left SVC drains ?
drains into coronary sinus –> r atrium; sometimes drains into L atrium (R to L shunt)
SVC syndrome presentation
facial/upper extremity edema and cyanosis; facial swelling improves with standing
acute is vascular emergency, chronic may be asymptomatic
common cause of SVC obstruction
compression by thoracic malignancy, catheter-associated thrombosis, mediastinal fibrosis (histoplasmosis)
vein of Sappey
drains liver near falciform ligament; communicates with internal thoracic vein (collateral to SVC occlusion)
increased hepatic IVa
treatment for SVC syndrome
stenting through IJ and femoral access
EKG finding to check for on pulmonary angiogram
L BBB
if pulmnary catheter causes R BBB, then you could get a complete heart block
pulmonary AVM is what type of shunt?
L > R
pulmonary AVM associated with?
HHT/Osler Weber Rendu
how to embolize pulmonary AVM? indication?
indication: asymptomatic with feeding artery > 4 mm or symptomatic (infarct, brain abscess)
coils; usually single feeding inflow artery (peripheral AVM usually have multiple branches)
particles can cause brain emboli/infarcts
massive hemoptysis definition, mortality from? involved vessels?
> 300 ml/24 hr, high mortality from asphyxiation; usually bronchial arteries
