Misc arterial testing

Question 1

How is arteriography preformed?

Answer 1

A thin catheter is inserted in a superficial artery, most common are CFA, axillary, or brachial. Contrast agent injected. Fluoroscopy used to obtain image. Patient remains supine for 6-8 hours with a sandbag over area to avoid bleeding.

Question 2

How does atherosclerotic plaque appear on arteriography?

Answer 2

irregular or smooth

Question 3

What is a vasospasm?

Answer 3

severe narrowing usually without occlusion

Question 4

Limitations of arteriography?

Answer 4

patients allergic to contrast or in kidney failure

inaccurate in its hemodynamic assessment because of inability to provide many images in multiple planes in real time

Question 5

Complications of arteriography?

Answer 5

hematoma, pseudoaneurysm, occlusion, neurologic complications

Question 6

What uses radio frequency energy and a strong magnetic field to produce images?

Answer 6

MR angiography

MRI instruments quantitate blood flow and construct images that look like angiograms. Show flowing blow without contrast

Question 7

Limitations of MRA?

Answer 7

• presence of metal clips, pacemakers
• can overestimate stenosis due to slow flow or turbulence
• expensive
• claustrophobia

Question 8

What are MRA useful for?

Answer 8

AAA, dissections, peripheral artery evaluation

Question 9

What is computerized tomography useful for?

Answer 9

size of aorta, extent of aneurysm, helps define relationship of aorta to renal artery origins

Question 10

How is aspirin helpful for arterial problems?

Answer 10

• It is an antiplatelet drug that decreases platelet aggregation resulting in decreased thrombotic activity
• Other medications help decreased blood viscosity
• Antihypertensive drugs serve to decrease forces against the walls

Question 11

What is the surgical removal of athersclerotic material, usually form the intimal lining?

Answer 11

Endarterectomy

Question 12

Common bypass grafts?

Answer 12

ao to iliac arteries (also used for AAA)
ao to bi-femoral (also used for AAA)
femoral to popliteal
femoral to PTA; to ATA; to Peroneal
other: renal artery, SMA

Question 13

What is used to dilate focal plaque formation in vessel?

Answer 13

angioplasty

percutaneous transluminal angioplasty

Question 14

How is the angioplasty preformed?

Answer 14

catheter with balloon tip is inserted and inflated to push plaque against the vessel wall

Question 15

What vessels are angioplasties usually preformed in?

Answer 15

renal, iliac, femoral, or popliteal

Question 16

What is used to maintain intraluminal structure/patency of artery? Acts as a type of scaffold.

Answer 16

stent/ stent graft

used in ao, renal, iliac, femoral, repair AAA

Question 17

Limitations of a stent?

Answer 17

abd gas, patient unable to lie flat, complications similar to arteriography

Question 18

Complications of stents

Answer 18

restenosis. stent migration, graft limb compression, twisting, dislodgment, leaks