Flashcards in Chap 87-91 Open Endovascular Technique Deck (43):
List occlusive clamps.
Debakey aortic aneurysm clamp
Fogarty aortic clamp
Lambert-kay aortic clamp
Wylie hypogastric clamp
List partially occluding clamps.
Lemole-strong aortic clamp
List self compressing clamps.
List different needle types.
Large aorta v7
List when to use what size fogarty.
2F small vessel pedal/hand
5F external iliac
6-7 graft saddle aortic
List adjunct to localizeing th eCFA for puncture.
What is the gauge of a puncture needle? micro puncture?
18 gauge (0.035)
21 gauge (0.018)
What is the pressure limit for flow through a multi holed and end hole catheter?
List different flush catheters.
List different single curved.
List different double curved.
List diffferent reverse curve
Name different crossing catheters.
What is nominal pressure?
Pressure required to expand the balloon to stated diameter
What is rated burst pressure?
Pressure at which 99.9% of balloons tested will not burst
What is compliance?
Amount a balloon will expand beyond its diameter as inflation pressure is increased
Do lower compliance balloon have higher or lower burst P?
What is trackability?
Ability to follow course of guide wire
What is push ability?
Columnar force transmitted to shaft of balloon catheter to tip of balloon
What size balloon for CIA?
List three devices used for crossing CTO?
corsser device (vibrate)
What are pros for BE?
high radial force/ongitudinal force
further expansion with larger balloons
What are cons for BE?
short lengths, prone to crushing
What are pros for SE?
flexible, longer length
continued radial force ir oversize
ability to clamp stent
What are cons for SE?
low radial force
What are indications for secondary stenting?
What are indication for primary stenting?
Heavily calcified ostial lesions
What are relative indications for aorta-uni?
Very small terminal aorta <15mm
Severe unilateral iliac occlusive disease
Secondary treatment of a short-body endograft migration
What are some anatomical considerations for EVAR?
neck diameter accomodate 10-20% oversize
iliac coverage 2cm
careful thrombus, conical, calcified, posterior bulges in neck
what are relative CI for perch closure?
severly scarred groins
high fem bifurcation
frequen introducer changes
significant prox iliac occlusive disease
small ilio fem
anterior calcific femoral
What are adjunct to facilitate contra limb cannulation?
don’t loose wire access on contra side/may be difficult to regain if tortuose
choose steerable angled wire
oblique fluoro view
antegrade access from brachial
convert to aorto-uni
What to look for on completion angio?
confirm patency of renal hypo
assess precision of LZ
eval for iliac dz
How to manage Type Ia?
compliant balloon if 5mm then consider aortic cuff
palmaz (5cm at 10mm expansion
33mm at 28 mm)
How to manage type Ib?
How to manage III?
How to manage renal artery coverage?
Pull caudally (wire over flow divider)
Snorkerl (best from brachial)
How to manage CIA aneurysm?
Can extend into EIA
Occlude the hypo
When to treat type II endoleaks?
evidence of type II with growth of 5mm
what are treatment options for type II?
coil or glue embo
transarterial (branch vessel, behind limb)
laparascopic IMA clipping
What are the landing zones of the arch?
0 up to distal in nom
1up to distal LCA
2 up to distal scla
3 prox DTA
4 mid-distal DTA
What are indications for spinal cord drainage?
extensive coverage thoracic aorta
LSCLA without revasc
dissection with malperfusion
List indications for LSCA revasc.
patent LIMA bypass
dominant l vert
left vert with terminate PICA
aortic arch origin of left vert
hypo or stenotic right vert artery
AVF in dialysis patient