Vascular Disease Flashcards
What is normal flow in the prox and distal aorta?
Prox: moderate resistance
Distal: high resistance
What is normal flow in the renal arteries?
Low resistance
What is normal flow in the SMA?
Pre-prandial: high resistance
Post-prandial: low resistance
What is normal flow in the portal veins?
Hepatopetal, monophasic with slight undulations
What is normal flow in the hepatic veins?
Phasic (influenced by respiration) and pulsatile (influenced by cardiac cycle)
What is normal flow in the IVC?
Phasic and saw tooth pattern
What are normal measurements for prox and distal aorta? What is considered aneurysmal?
Prox: 2-2.5cm
Distal: 1.5cm
Aneurismal: >3cm
What is normal IVC measurement?
<25mm
What is a true aortic aneurysm vs ectasia?
True: >3cm and all wall layers involved
Ectasia: slight widening up to 3 cm
Where on the aorta do aneurysms mostly occur?
Below the renal vessels
What type of aortic aneurysm is most common?
Fusiform
What measurement of AAA indicates surgery imperative?
5-6cm
What is the most common complication of AAA? Most critical?
Stenosis/occlusion
Rupture: most critical
What splanchnic/mesenteric aneurysm is first and second most common?
Splenic is most commonly affected, followed by hepatic
What are the 3 types of aortic dissection and which is most common?
- Ao arch and moving down AO
- Marfan’s- ascending AO only
- Descending AO after origin of LT subclavian- most common
What is the most common cause of pseudoaneurysms?
Failed graft/post angiogram
What is an AV fistula and how does the blood flow in one?
Abnormal communication between an artery and a vein, blood flows from high pressure to low (artery to vein)
Where is renal artery stenosis commonly originating and what is it associated with?
Associated with uncontrollable hypertension and is usually at origin from AO or close to
What 4 things do we look for when assessing the IVC?
- Changes with respiration
- Compressibility
- Echo free lumen
- Patency
What is the most common cause of a dilated IVC?
Right ventricular failure
What is the most common metastatic tumour of the IVC?
RCC
What is the most common abnormality of the IVC?
IVC thrombosis
Briefly describe the 3 congenital abnormalities of the IVC
- Transposition: IVC starts on the LT side and drains into LT renal and becomes RT IVC
- Duplication: 2 IVC’s up to the renal vein
- Azygous Continuation: hepatic part of the IVC did not develop, blood drains into the Azygous system which drains into the SVC
Passive edema of the liver secondary to vascular congestion and related to heart failure
Hepatic congestion
What are the 2 major types of portal hypertension?
- Presinusoidal
2. Intrahepatic
What are the 2 subcategories of presinusoidal portal hypertension?
- Extrahepatic
2. Intrahepatic
What is the most common cause of intrahepatic portal hypertension?
Cirrhosis
What are 3 signs of intrahepatic portal hypertension?
Ascites, splenomegaly, collaterals
What is the upper limit of normal for MPV?
<13mm
What are the sonographic signs of portal HTN?
- dilated PV in early stages
- collateral flow
- patent umbilical vein
- ascites
- splenomegaly
- PV flow monophasic -> biphasic -> hepatofugal
What collateral is the most dangerous?
Gastroesophageal
What is the most common treatment for portal HTN?
Portosystemic shunts
What is TIPS?
Transjugular intrahepatic portosystemic shunt
What can be associated with portal vein thrombosis?
Cavernous transformation (“can of worms”)
What is Budd-Chiari syndrome?
Obstruction of the hepatic veins (varying degree)
What is an infarction?
Sudden loss of blood supply
What is a splenic infarct?
Caused by occlusion of the SA, appears as a hypoechoic, wedge shaped/round area
What is the Sonographic appearance of renal infarctions?
Early: hypoechoic
Resolving: echogenic
What disease is strongly associated with typical AAA?
Atherosclerosis
What is the most common primary tumour of the IVC?
Leiomyosarcoma
