P3

Question 1

Gaining _____ is the first and most critical step for the majority of interventional radiology procedures.

Answer 1

vascular access

Question 2

preferred for central venous access, especially in patients requiring long-term venous access or central lines.

Answer 2

Neck (e.g Internal Jugular Vein)

Question 3

Frequently used for large bore access in arterial interventions, catheter- based treatments and emergency procedures.
(Percutaneous Transluminal Angiography, Angioplasty)

Answer 3

Groin (eg. Common Femoral Artery/Vein)

Question 4

increasingly popular for coronary and peripheral interventions due to lower bleeding risk and patient comfort. (Angioplasty, Stent Placement).

Answer 4

Extremities (eg. Radial Artery)

Question 5

Preferred sites for vascular access

Answer 5

Neck
Groin
Extremities

Question 6

Pre-Procedure Evaluation

Answer 6

Inspect the access site
Ultrasound guidance

Question 7

Patient Preparation

Answer 7

Sanitize and Drape
Sterile Technique
Local Anesthesia

Question 8

_____ is administered in the access site

Answer 8

1-2% lidocaine

Question 9

Vascular Access Technique
Positioning and needle insertion

Position the ultrasound probe ____ to the skin.

Insert the needle at a shallow angle ( _____degrees) _____ to the probe, with the bevel facing upward.

Ensure the needle trajectory ____ with the ultrasound plane to maintain continuous visualization.

Answer 9

perpendicular
20-30, parallel
aligns

Question 10

use a _____ motion with the UTZ probe to differentiate the needle tip from the shaft.

Answer 10

gentle rocking

Question 11

Bright Red and pulsatile

Answer 11

Arterial Blood

Question 12

Dark red and Slow, non-pulsatile

Answer 12

Venous Blood

Question 13

perform ____ with a syringe if unsure of entry

Answer 13

gentle aspiration

Question 14

Monitor guidewire movement under ____ to ensure intravascular placement.

Answer 14

ultrasound or fluoroscopy

Question 15

Vascular Access Technique

Answer 15

Positioning and Needle Insertion
Needle Visualization
Confirm Vessel Entry

Question 16

Seldinger Technique for Vascular Access

Answer 16

Guidewire Insertion
Skin Nick
Dilator and Sheath Placement

Question 17

In seldinger technique, use a ____ blade scalpel to make a small skin incision at the guidewire entry

Answer 17

11

Question 18

Apply direct pressure for ___ minutes if venous access is required

Answer 18

5-10

Question 19

Is a critical component of most interventional radiology procedures

Answer 19

Venous Access

Question 20

Common access sites

Answer 20

Internal Jugular Vein and Femoral Vein)

Question 21

The ____ is typically preferred due to its straighter course to the heart.

Answer 21

Right Internal Jugular Vein

Question 22

Advantages of Right IJV:

Answer 22

•Easier navigation to central veins.
•Reduces catheter kinks and bends.

Question 23

Located medial to the femoral artery

Answer 23

Femoral Vein Access

Question 24

Best Practices for IJV Access:
•Maintain needle trajectory approximately ____ above the clavicle.
•Use the right IJV when possible for optimal access.

Answer 24

1 cm

Question 25

____ access is a critical component of vascular and interventional procedures.

Answer 25

Arterial

Question 26

The most common arterial access points are:

Answer 26

•Femoral artery •Radial artery •Brachial artery

Question 27

Other access points, such as _____, are used for specific peripheral vascular interventions.

Answer 27

pedal or antegrade arterial access

Question 28

Most common site for arterial interventions

Answer 28

Femoral Artery Access

Question 29

Preferred for lower extremity interventions, including recanalization of tibial or femoropopliteal occlusions

Answer 29

Femoral Artery Access

Question 30

•Visible via ultrasound but manual compression is less effective. •Used when femoral access is not feasible (e.g., severe aortoiliac disease).

Answer 30

Brachial Artery Access

Question 31

•Increasingly preferred in both cardiology and interventional radiology.

Answer 31

Radial Artery Access

Question 32

is a collection of clotted blood that forms outside of a blood vessel.

Answer 32

Hematoma formation

Question 33

•Occurs when the arterial puncture site fails to seal.

Answer 33

Pseudoaneurysm

Question 34

•Tear in the tunica intima causing a false lumen.

Answer 34

Arterial Dissection

Question 35

•Formed when both the artery and vein are punctured.

Answer 35

Arteriovenous Fistula (AVF)

Question 36

•Due to plaque disruption or atheroembolism.

Answer 36

Distal Ischemia

Question 37

Only patients with _____ collateral circulation are candidates for radial access

Answer 37

adequate

Question 38

Inadequate ulnopalmar patency (<2% of patients)

Answer 38

Grade D

Question 44

involves the placement of a catheter into a large vein to provide reliable access to the central circulation.

Answer 44

Central venous access

Question 45

•Inserted via peripheral veins (basilic, cephalic, or brachial).

Answer 45

Peripherally Inserted Central Catheter (PICC)

Question 46

•Common insertion sites: Internal jugular (IJ), subclavian, or femoral veins. •Indications: Emergency access, short-term use. 10 days to 2 weeks. •Higher risk of dislodgement and infection over time.

Answer 46

Non tunneled Central Line

Question 47

•Inserted with a subcutaneous tunnel to reduce infection risk and improve catheter stability.

Answer 47

Tunneled Central Line

Question 48

•Fully implanted under the skin with a reservoir.

Answer 48

Implantable Port (Port-a-Cath)

Question 49

Occur during the procedure (uncommon due to image guidance).

Answer 49

Immediate Complications

Question 50

Typically involve catheter malfunction.

Answer 50

Late Complications

Question 51

Occurs when air enters the sheath after dilator removal.

Answer 51

Air embolism

Question 52

Kinking due to acute catheter angles.

Answer 52

Catheter Malfunction

Question 53

Layering of material around the catheter tip.

Answer 53

Fibrin Sheath Formation

Question 54

is a common nonvascular procedure performed by interventional radiologists (IR).

Answer 54

Percutaneous enteric access

Question 55

1.Enters the stomach through the abdominal wall. 2.Suitable for patients with normal anatomy and small bowel motility.

Answer 55

Gastrostomy (G-tube)

Question 56

1.Tip resides in the jejunum. 2.Ideal for patients with severe reflux or gastric outlet obstruction.

Answer 56

Gastrojejunostomy (GJ-tube)

Question 57

1.Direct entry to bowel through the abdominal wall. 2.Used for patients with prior gastrectomy or biliary-jejunal anastomosis.

Answer 57

Jejunostomy (J-tube) or Cecostomy

Question 58

•is a minimally invasive procedure to drain fluid collections within the body. •It has largely replaced open surgical drainage due to lower complication rates and better clinical outcomes.

Answer 58

Transcatheter fluid drainage

Question 59

: Commonly due to recent surgery or infection along the bowel.

Answer 59

Abscesses

Question 60

Generally should not be drained unless infected, as sterile hematomas are better left undisturbed.

Answer 60

Hematomas

Question 61

refer to the accumulation of fluid within the chest cavity. The most common type is pleural effusion

Answer 61

Intrathoracic fluid collections

Question 62

•Long-term, tunneled pleural drains for patients with malignant effusions. •Designed for home use with periodic self-drainage or home health assistance.

Answer 62

PleurX Catheters

Question 63

•Caused by thoracic duct trauma, often following cardiothoracic surgery. •Diagnosed by milky-white drainage and positive chylomicrons in pleural fluid.

Answer 63

Chylothorax