Lesson 18 - CV Correlative Imaging & Invasive Therapeutic Intervention Flashcards
Name the 2 types of angiography exams
- conventional
- digital subtraction (DSA)
Name the 3 types of correlative imaging
- Angiography
- Computed tomography angiography (CTA)
- Magnetic resonance angiography (MRA)
Which method uses xray and contrast?
Conventional angiography (aka arteriography)
why is contrast required for conventional angiography?
to visualize arteries
Who would be a bad candidate for conventional angiography?
Why?
Pts with poor renal function
cannot have contrast
What is a complication related to conventional angio?
allergic reation to contrast
what type of angio used digital subtraction?
3D angio
What is a CT Angiography?
is contrast required?
what plane are images acquired?
sectional imaging, 3D reconstruction
yes
trans
what method was used here?
CT angiography. its a reconstructed head
What is a MRA?
is contrast required?
Is it an easy exam for patients?
what is the machine used called?
Uses magnetic field and radio wave pulses to create image
Contrast required
Some patients don’t tolerate it well as they take quite a while and the space is more enclosed
gantry
what method was used here?
MRA
*cleaner planes
what are the medical treatement options for a pt w/ atherosclerotic dx ?
what are the endovascular options for this pt?
what are the surgical options for this pt?
is there anything else that can be offered?
reduction of risk factors: lifestyleor Pharmacologic control (HTN, cholesterol, Clotting factors)
Percutaneous transluminal angioplasty (PTA) or a Stent
Endarterectomy or Bypass graft
acute thrombolitic therapy (catherter up and injected to get rid of clot)
____ therapy is a good Option for patients with <50% or high risk of perioperative stroke which would incl:
Occlusion of contralateral artery
Intraluminal thrombus
Severe CAD, chronic obstructive lung disease and renal insufficiency
Life expectancy >5 years
treatement options would consist of:
Antihypertensive drugs
Weight control and diet
Decrease smoking
Attempt to control DM
Anticoagulent (antiplatlet) therapy – aspirin, persantine
medical
Angioplasty/Carotid Stenting treatment is an option of _____ therapy.
Dilatation of vessel via catheter and balloon procedure via groin or arm access.
Placement of stent via catheter.
Flow filters available to reduce emboli
Risk of emboli, reduced with filters
this method is a good Option for patients w/ (2)
endovascular
high-risk for peri-operative strokes (see previous slide)
stenosis extends beyond surgical assess point
what does this look like?
a stent
________ consists of:
Incision into vessel
Removal of intima and plaque
Closure of vessel, may include a “patch” to widen the vessel.
US – will see step off of the intima.
it is a ______ procedure.
carotid endarterectomy (CEA)
surgical.
What type of exam is this?
sonography
computed tomography arteriography
conventional angiography
magnetic resonance arteriography
conventional angiography
What is demonstrated by the arrow?
occlusion
stenosis
aneurysm
pseudoaneurysm
stenosis
What type of exam is this?
extracranial magnetic resonance arteriography
intracranial conventional angiography
intracranial magnetic resonance arteriography
extracranial conventional angiography
intracranial MRA
What is demonstrated on this diagram?
ECA stenting
ICA stenting
ECA angioplasty
ICA endarterectomy
ICA stenting
Carotid endarterectomy is
compression of the intima and plaque within the vessel with a balloon
occlusion of the vessel with thrombic agents
surgical removal of the intima and plaque within the vessel
expansion of the vessel lumen with a stent
surgical removal of intima and plaque
