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Vascular > Venovo- Venous Information > Flashcards

Venovo- Venous Information Flashcards

1
Q

Artery composition

A
  • more muscular, thicker walls
  • smaller lumens
  • no valves
  • more elastic, less compliant
  • higher blood flow rates
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2
Q

Vein composition

A
  • thinner walls
  • larger lumens
  • bicuspid valves
  • less elastic, more compliant
  • 70% of the body’s blood
  • lower blood flow rate
  • higher degree of variability
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3
Q

arteries are more ____, less __________.

A
  • elastic
  • compliant
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4
Q

veins are more ______, less _______.

A
  • compliant
  • elastic
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5
Q

elasticity definition

A

the ability to return to size/ shape after deformation. It is NOT stretchiness of the vessel

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6
Q

Compliance definition

A

is the ability to yield to increase pressure

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7
Q

elasticity and compliance have an inverse relationship. The more compliant a vessel is, the ___ elastic it can be.

A

less

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8
Q

venous valves > 2mm have bicuspid valves to prevent ______.

A

Reflux

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9
Q

for venous valves, divide the hydrostatic column of blood into small segments, this helps maintain _____.

A

flow direction

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10
Q

valves open when the blood is flowing ______ the heart and ______ when the pressure gradient is _______.

A
  • toward
  • closed
  • reversed
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11
Q

the short period of reflux before valves close is

A

<0.5 seconds

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12
Q

Average diameter of the inferior vena cava

A

18-24 mm

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13
Q

average diameter of common illiac vein

A

16-18 mm

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14
Q

average diameter of external illiac vein

A

14 mm

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15
Q

average diameter of common femoral vein

A

12 mm

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16
Q

average area of inferior vena cava

A

300-400mm^2

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17
Q

average area of common illiac vein

A

200-250mm^2

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18
Q

average area of external illiac vein

A

150mm^2

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19
Q

average area of common femoral vein

A

110mm- 125^2

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20
Q

what is the purpose of stenting?

A

restore lumen area to reduce venous congestion and lower venous pressures

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21
Q

T/F: veins typically have larger diameters and luminal area than their arterial counterparts

A

True

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22
Q

Physicans often refernce vein area instead of ______.

A

diameter

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23
Q

Common femoral vein diameter, length, area

A
  • 12 mm diameter
  • 60 mm length
  • 125 mm^2 area
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24
Q

external iliac vein diameter, length, area

A
  • 14 mm diameter
  • 130 mm length
  • 150 mm^2 area
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25
Q

common iliac vein diameter, length, area

A
  • 16 mm diameter
  • 60 mm length
  • 200 mm^2 area
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26
Q

inferior vena cava diameter, length, area

A
  • 18-24 mm diameter
  • 140 mm length
  • 300- 400 mm^2 area
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27
Q

Recurrent DVT, pulmonary embolism (PE), and post-thrombotic syndrome (PTS) are risk of thrombosis of ____ and ____.

A

femoral, iliac veins

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28
Q

There are ___ main ways to classify VTE severity

A

4

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29
Q

T or F: approximately 80% of patients with DVT in the iliofemoral veins are not being treated successfully with conventional therapy

A

True

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30
Q

what stands for clinical, etiological, anatomical, and pathophysiological

A

CEAP

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31
Q

In which stages do patients become eligable for deep venous treatments according to CEAP?

A

stages C3-C6

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32
Q

What was created to supplement CEAP and enable longitudinal patient surveillance

A

VCSS

33
Q

an assessment designed specifically for PTS

A

Villalta

34
Q

a patient reported quality of life (QoL) assessment

A

CIVIQ-20

35
Q

which venous classification tool asks physical and psychological questions?

A

CIVIQ-20

36
Q

The (‘16-‘26) CAGR for venous stenting is

A

7.9%

37
Q

Stages of _____/ _____ include: anitcoagulation, mechanical prophylaxis, and IVC filter

A

prevention/ management

38
Q

stages of ______ include: Throbosis, thrombectomy, and venous stent

A

intervention

39
Q

oldest and most common anticoagulation method, oral therapy

A

warfarin/ coumadin

40
Q

immediate effect and decreases fatal PE by 75% through injection

A

Heparin

41
Q

novel oral anticoagulaion, intented to eventually replace warfarin

A

NOAC: Rivaroxaban & Apixaban, Dabigatran

42
Q

Virchow’s Triad includes 3 factors in the formation of venous thrombolism

A
  • venous stasis
  • coagulation
  • vein damage
43
Q

what % of DVT occurs in the common femoral or iliac veins?

A

40%

44
Q

symptoms of DVT

A

swelling pain, warmth, enlarged veins and skin discoloration

45
Q

acute clot age and description

A
  • <14 days
  • a clot that is still soft enough and more easily removed
46
Q

subacute age and description

A
  • 14-28 days
  • DVT that is organizing from a soft thrombus into collagenous scar tissue and integrating into the vein
47
Q

chronic age and description

A
  • > 28 days
  • tough, collagenous tissue that has integrated into the wall of the vein
48
Q

Peripheral Artery Disease (PAD)

A
  • smoking, diabetes, high cholesterol, hypertension
  • ages 65+
  • both men and women
  • high amputation risk
49
Q

Venous Thrombembolism (VTE)

A
  • obesity, pregnancy, cancer, autoimmue disorders
  • most common in 50+, but can occur at any age
  • both men and women, but higher in women in childbearing years
  • lower amputation risk
50
Q

consequences of DVT/ PE

A
  • 100k yearly deaths in US
  • 548K yearly hospital admissions
  • 33% recurrence in 10 years
  • 50% develop PTS
  • annual healthcare cost $2-10 billion
51
Q

post thrombotic syndrome

A
  • results from the damage of accumulated chronic DVT
  • narrowing causes outflow issues and hypertension
  • valve damage causes chronic venous insufficiency
  • venous ulcer are common in advanced cases
52
Q

may-thurner syndrome

A
  • compression of the left iliac vein by right iliac artery
  • up to 25% of all DVT cases
53
Q

suggested treatment of may-thurner syndrome

A

suggested treatment is removal of acute clot via thrombolysis, angioplasty + stent of compression lesion

54
Q

DVT & PE prevention three options:

A
  • anticoagulation
  • mechanical prophylaxis
  • IVC filter
55
Q

anticoagulation role in DVT & PE prevention

A
  • blood thinning medication
  • gold standard
56
Q

mechanical prophylaxis role in DVT & PE prevention

A
  • compression stockings, pneumatic devices
  • gold standard
57
Q

IVC filter role in DVT & PE prevention

A
  • to help prevent recurrent PE
  • does not address DVT
58
Q

heparin ( acute therapy via injection)

A
  • decreases fatal PE by 75%
  • reduces recurrent PE from 30% to 8%
  • not feasible long term
59
Q

coumadin/ Warfarin (continous oral therapy)

A
  • difficult dosage control
60
Q

novel oral anticoagulation (NOACs)

A
  • dabigatran, rivaoxaban, and apixaban
  • expensive
  • no reversal treatment
61
Q

anticoagulation contraindications

A
  • active or recent hemorrhage
  • peptic ulcer disease
  • previous complications from anticoagulation
  • hemorrhagic stroke
  • surgery involving brain or spinal cord
  • fall risk
62
Q

anticoagulation complications

A
  • resistance to anticoagulation
  • major bleeding
  • recurrent PE
63
Q

mechanical methods of prophylaxis

A
  • graduated compression stockings (GCS)
  • intermittent pneumatic compression (IPC) devices
  • Venous foot pump (VFP)
64
Q

What to do for those patients with documented DVT/ PE who are not candidates for anticoagulation and/or do not respond to anticoagulation or mechanical prophylaxis?

A

IVC filter

65
Q

Venous disease interventional treatment options

A
  • thrombolysis
  • Thrombectomy
  • Venous stent
66
Q

goal of interventional treatment

A
  • reestablishblood flow
  • relieve symptoms
  • limit the risk of PE
67
Q

considerations for interventional treatment

A
  • extensive or proximal DVT involving the IVC or iliofemoral veins
  • high risk of PTS
  • younger patients
  • high risk of fatal PE
  • DVT despite anticoagulation
  • antatomic lesions I.E. may thurner or pelvic tumors
68
Q

What is thrombolysis?

A
  • systemic or catheter directed
  • effective for acute clot removal
69
Q

thrombolysis limiters:

A
  • risk of bleeding complications
  • increased risk of PE
  • not effective on chronic thrombus
  • doesn’t address cause of compression syndrome
70
Q

what is thrombectomy?

A
  • surgical, mechanical, or pharmaco-mechanical
  • effective for acute clot removal with limits for sub-acute
71
Q

thrombectomy limiters

A
  • increased risk of PE
  • not effective on chronic thrombus
  • doesn’t address cause of compression symptoms
72
Q

when and why should you stent?

A
  • AHA reccomends when other options have been exhausted
  • literature shows stenting can restore integrity of the vessel and re-establish flow
73
Q

venography

A
  • venogram is usually preformed
  • AP/RAO/LAO views are recommended
  • venous disease, especially compressive lesions, may not be visible
  • (look for “pancaking vessel”)
  • look for collaterals to indicate underlying problem
  • can not completely characterize the disease or degree of stenosis
74
Q

why IVUS?

A
  • illiac vein size
  • confirmation of venous compression syndromes
  • stent apposition post deployment
  • exact location of IVC bifurcation: stent placement in relation to bifurcation
  • identifying disease free landing zone- vital for patency
  • extent of stenting as per catheter cm markings
75
Q

IVUS stent sizing reccomendations:

A
  • (max diameter + min diameter)/2
  • add 1-3 mm for self expnding stent size
  • post-dilate to actual size of vessel
76
Q

True or False: Venography is used for both diagnostic and intraprocedural imaging.

A

True

77
Q

Which of the following is a negative aspect of venography?

A

high radiation

78
Q

What are positive aspects of IVUS?

A
  • Ability to measure diameters and areas
  • Accuracy identifying lesion location
  • No radiation
  • Reduces need for contrast
79
Q

True or False: Veins are more elastic but less compliant than arteries.

A

false

Vascular (24 decks)

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