Kapitel 108 – vascular surgery Flashcards
List the layers of blood vessels
a. Tunica adventitia (tunica externa)
b. Tunica media
c. Tunica intima
Name the instruments
From left to right: microvascular needle holders, without catch, curved Vannas microvascular dissecting scissors, straight adventitial scissors, jeweler’s forceps, and curved and straight mosquito hemostats.
Name the instruments
Arteriotomy clamp. The open tip allows for accurate assessment of the depth of the arteriotomy (inset).
Name the instruments
From left to right: a DeBakey atraumatic angled vascular clamp, DeBakey atraumatic tangential clamps, a DeBakey-Satinsky atraumatic tangential clamp, a Cooley atraumatic clamp, a DeBakey atraumatic multipurpose curved clamp, and a Castaneda atraumatic neonatal clamp.
Name the instruments
From left to right: microvascular needle holders, without catch, curved Vannas microvascular dissecting scissors, straight adventitial scissors, jeweler’s forceps, and curved and straight mosquito hemostats.
What are the general size of sutures used in a vessel with diameter of 4-6 mm, 2-3 mm and less than 2 mm?
a. 4-6 mm –> 4-0 to 5-0 suture
b. 2-3 mm –> 6-0 suture
c. < 2 mm –> 7-0 to 8-0 suture
When is the use of systemic anticoagulants indicated in small animal surgeries?
a. Cardiac surgery requiring bypass
b. adrenalectomy for adrenocortical tumors
c. placement of vascular autografts and prosthetics
d. canine renal transplantation.
You are preforming an arteriotomy on a 3 mm diameter vessel. Do you place you incision longitudinally or transverse? Why?
a. Transverse, to reduce the risk of lumen narrowing and thrombus formation.
(a transverse incision sound not extend beyond 180 ° of the vessel circumference.)
Briefly describe how to close an incised vessel
a. Excessive tunica adventitia should be excised to prevent it from being included in the lumen of the vessel. This can lead to narrowing of the lumen, obstruction of blood flow and possible thrombus formation.
b. All layers should be included in the suture, especially the tunica intima.
c. Suture are placed 1 mm apart and 1 mm from the cut edge (except when vessels are enlarged, thickened, or diseased)
d. Can be continuous or interrupted.
List three different techniques of end-to-end anastomoses
a. A simple end-to end begun with two double-armed sutures placed 180 degrees apart and run continuously toward each other on either side.
b. The oblique end-to end- technique
c. The triangular technique
When is end-to-side anastomoses used in vet medicine?
a. feline and canine renal transplantation
b. grafting of free vascularized segments of skin and muscle
c. and palliation of tetralogy of Fallot using a modified Blalock-Taussig shunt.
Through which vessel are arterial and venous access typically gained during endovascular surgery?
a. Carotid artery (arterial access)
b. Jugular vein (venous access)
How do you estimate the appropriate length of a centra venous catheter?
by measuring from the jugular access site to the caudal aspect of the ipsilateral triceps muscle or first rib
What is the picture showing?
The Companion Port, a subcutaneous vascular access port system with a single-wall needle, peel-off sheathed needle, right-angle Huber infusion set, and titanium port with silicone septum.
List procedures where embolization can be used
a. reduction of active hemorrhage
b. occlusion of patent ductus arteriosus
c. attenuation or closure of intrahepatic and extrahepatic portosystemic shunts and hepatic and peripheral AV fistulas
d. palliative treatment of inoperable neoplasm
