P2

Question 1

Should be assessed for any patient undergoing IR

Answer 1

Bleeding Risk

Question 2

are those which are minimally traumatic with small access device, or those which access is obtained into a space which bleeding would be easily detected and controlled

Answer 2

Low Risk

Question 3

Are when solid organ is traversed.

Answer 3

High Risk

Question 4

• a blood test that measures how long it takes your blood to clot.

Answer 4

INR (International Normalized Ratio)

Question 5

Platelet Count must be ____

Answer 5

> 50,000

Question 6

• An important consideration in IR procedures, due to moderate sedation.

Answer 6

Apiration Risk

Question 7

Includes pre existing conditions

Answer 7

CIN (contrast induced nephropathy)

Question 8

procedures involving the HBT, genitourinary, or gastrointestinal
systems are considered contaminated, and require a ____

Answer 8

prophylactic antibiotic

Question 9

Conscious sedation is typically accomplished using _____

Answer 9

midazolam and fentanyl

Question 10

Vascular Procedure is pioneered by

Answer 10

Dr. Sven-Ivar Seldinger

Question 11

• Most common method used for obtaining a vascular access

Answer 11

Seldinger Technique

Question 12

• narrow in diameter used to administer local anesthesia.

Answer 12

Hypodermic Needles

Question 13

– are used to access target vessels.

Answer 13

Guidewires

Question 14

– spreads the overlying subcutaneous tissue and the vessel wall.

Answer 14

Dilators

Question 15

– are tubes inserted to the access site, allows insertion and exchange of instruments into the vessel.

Answer 15

Sheaths

Question 16

– hollow tubes also used to navigate the select target vessels

Answer 16

Catheter

Question 17

involves in treating the vessel by expanding a balloon within the lesion and exerting outward radial pressure to fracture the lesion(plaque).

Answer 17

Balloon Angioplasty

Question 18

• the amount of pressure required for the balloon to assume its listed diameter.

Answer 18

Nominal Pressure

Question 19

• refers to how much pressure the balloon can safely withstand without bursting

Answer 19

Burst Pressure

Question 20

• molds to the vasculature contour as they are inflated.

Answer 20

Compliant Balloons

Question 21

• smaller increase in diameter per unit pressure increase.
• ideal for angioplasty of heavily calcified lesions.

Answer 21

Non-compliant Balloons

Question 22

• most commonly used in angioplasty.
• can continue to expand with increasing pressure at a much slower rate

Answer 22

Semi-compliant Balloons

Question 23

• are scaffolds that are placed within the vessels or ducts to maintain
  the luminal surface area.

Answer 23

Stents

Question 24

Two main categories of stents

Answer 24

Self Expanding Stents
Balloon Expandable Stent

Question 25

- made out of nickel-titanium alloy (nitinol)

Answer 25

Self Expanding Stents

Question 26

- they are mounted on a balloon catheter, delivered to the target lesion, the balloon is then inflated to facilitate expansion

Answer 26

Balloon Expandable Stent

Question 27

- a technique used to cause blockage of flow within a vessel. - embolic agents includes coils, plugs, particles, and sclerosants are delivered through catheters to carry out the occlusion.

Answer 27

Embolization

Question 28

- workhorse of embolization, can stop bleeding or redirect blood flow. - titanium, tungsten, platinum, nitinol, or stainless steel. - size ranges from 0.010 to 0.035 inch, can determine the softness of the coil

Answer 28

Metallic Coils

Question 29

- are loaded into the catheter, and are either pushed from behind using a wire, or flushed with saline. - once they are deployed, their position cannot be adjusted

Answer 29

Pushable Coils

Question 30

- are disc shaped or cork-like baskets woven together with nitinol wires that promotes vessel occlusion an d activation of the intrinsic clotting cascade. - they are detachable, allowing a more precise positioning

Answer 30

Vascular Plugs

Question 31

- are microscopic spheres or polygons with diameters between 40 and 1300 microns. - constructed with tri-acryl gelatin(TAGM) and polyvinyl alcohol (PVA).

Answer 31

Particles

Question 32

- a biologic agent derived from dermal gelatin. Hemostatic agent used in surgery

Answer 32

Gelfoam

Question 33

- are agents such as sodium tetradecyl sulfate, polidocanol and ethanol. Which damages the endothelial and medial cells within a vessel wall which leads to scarring and vessel destruction, platelet activation and coagulation cascade activation. - typically use in veins to treat lymphovascular malformation

Answer 33

Sclerosants

Question 34

- once the procedure is done, guidewire, catheter and sheath need to be removed. The hole in the vessel needs to be closed. - a simple manual compression for a few minutes

Answer 34

Closure Device

Question 35

- involve draining fluid collections, sampling of tissue, intervening on the urinary bladder and gallbladder, and injecting material for therapeutic purposes. - access thru Seldinger or Trocar Technique

Answer 35

Nonvascular Procedures

Question 36

- drainage catheters are inserted in the body to aspirate fluid collection, or left in place for continuous drainage

Answer 36

Drainage Procedures

Question 37

- requires the guidance of CT-scan or Ultrasound for needle placement. While ensuring there are no vital structures along the way.

Answer 37

Biopsy Procedures

Question 38

- involves inserting an initial larger diameter needle to the edge of the lesion. A thinner and longer needle is then inserted to the larger needle, and advanced into the lesion. - major advantage, only one puncture is made

Answer 38

Coaxial Technique

Question 39

- uses an initial reference needle placed into the lesion, with the biopsy needle then placed in tandem, using the reference needle’s depth and trajectory

Answer 39

Tandem Technique

Question 40

- provide cells from the lesion for cytology. Needles used range from 20 and 25 gauge

Answer 40

Fine Needle Biopsies (FNAB)

Question 41

- larger needle (14 to 20 gauge) is used, to extract a chunk of tissue

Answer 41

Core Biopsy