Week 4 Part 1 Flashcards
Carotid body tumors are also known as
paragangliomas
Where are carotid body tumors located?
in the adventitia of the carotid bifurcation– b/w ICA and ECA
What is the most common presentation of a carotid body tumor?
palpable neck mass with headache
neck pain is second most common
What is the standard treatment for carotid body tumors?
resection
if untreated, stenosis, occlusion or rupture could occur
On 2-D and CD, ICA and ECA appear
splayed
What demonstrates vascular nature of mass prior to surgery
arteriography
Carotid body tumors can be mistaken for what?
node
Do CBT have high or low vascularity?
lots of flow but low speeds
Who does FMD typically affect?
women ages 25-50
not genetic but familial
What’s the most common site for FMD? What’s the second most common?
renal arteries, ICA
FMD presents with
system hypertension caused by renal artery stenosis
When carotids are involved with FMD, what does this present as
transient cerebral ischemia (stroke can occur)
What does FMD appear as on angiography?
string of beads
Which layer of the vessel is most often involved with FMD?
tunica media
What’s the typical flow in a vessel with FMD?
long stenosis but no atherosclerosis
flow disturbances
elevated velocities- 200cm/s
What are some vascular diseases of the fem artery? (3)
PSA
AVF
Penetrating arterial trauma
What is the most common entry route in the fem artery for a PSA?
groin area
PSA’s arise from the deep portion of the artery at the site of the puncture. True or false
false– superficial aspect
PSA usually occur at the ______ but may be as high as the ______
CFA, EIA
What’s the most common treatment for PSA?
US guided compression or thrombin injection
If a PSA is found it is treated right away. True or false
true– because of risk of expansion
What is an AVF usually caused by?
iatrogenic during cardiac catheterization
What can be seen and heard with a AVF?
thrill (it’s palpable)
color bruit artifact (mosaic?)
Downstream from the AVF, Doppler demonstrates what flow?
high velocity, pulsatile venous
What’s the most common cause of penetrating arterial trauma?
non-iatrogenic injuries– GSW and stabbings
What is Takayasu’s arteritis also known as?
aortic arch syndrome or pulseless disease
What is Takayasu’s arteritis?
form of large vessel granulomatous vasculitis
massive intimal fibrosis and vascular narrowing is a sign
Who does Takayasu’s typically affect?
young or middle aged women of Asian descent
females 9x more likely and symptoms appear b/w 15-30
What vessels does Takayasu’s usually affect?
mainly the aorta and it’s major branches– INN, lt. CCA, lt. SCA and pulmonary arteries
Symptoms and signs of TA?
pulseless upper extremities
malaise, fever, night sweats, weight loss, fatigue and syncope
SSS may be evident
Oscar, you’re gay
boom roasted
What can TA lead to? What’s the treatment?
stenosis, thrombosis and aneurysm
steroids, surgery or stenting
What is giant cell arteritis known as?
temporal arteritis or Horton disease
What is giant cell arteritis?
inflammatory disease of blood vessels most commonly large and medium branches of the head (particularly ECA)
can lead to occlusion and ischemia (worst is of OA)
Is giant cell arteritis more common in men or women? What geographic region?
descent of northern Europe and women
GCA is typically seen in those under 55. True or false
false
What does giant cell arteritis present as?
bruits, fever, headache, visual disturbances, tenderness of scalp and OA can be involved
What sign does GCA show on US?
halo sign
What is Buerger’s disease also known as?
Thromboangitis
Who do we typically see Buerger’s disease in?
Young males who smoke cagrettes
What happens in Buerger’s disease?
blood vessels in fingers and toes become blocked because of the swelling. Fingers and toes become black
Radiation induced arterial injury
radiation-induced stenoses of the carotid artery are associated with fibrosis of the arterial layers and tissue planes that renders their surgical treatment difficult
What types of cancers increase the risk of developing a vascular disease
breast, lymphoma, head and neck cancer patients
A course of radiotherapy can initiate a chronic vascular process that eventually leads to clinical events
many years after treatment due to inflammation
What’s the treatment for “hostile neck” patients
stenting
