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RVT Review > Chapter 15 > Flashcards

Chapter 15 Flashcards

1
Q

what is an arteriography?

A

percutaneous puncture of superficial artery; insertion of thin catheter

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2
Q

which arteries are used for arteriography?

A

CFA (safest approach), axillary, brachial

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3
Q

how does the arteriography work?

A

after proper positioning, contrast agent injected into catheter, flows with moving blood, gives picture of lumen
rapid film changer technq used to expose the films sequentiallly as contrast agent moves through vessel
using fluoroscopy, digital info obtained/stored for later manipulation/ interpretation

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4
Q

what is the recovery for arteriography?

A

catheter removed, pressure held on puncture site; patient supine for 6-8 hours. sandbag placed on top of dressing to help avoid bleeding

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5
Q

T/F arteriography is a anatomic study not a functional study

A

true

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6
Q

how is a significant stenosis usually defined by an arteriography

A

50% diameter reduction

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7
Q

what is the interpreation of an arteriography?

A

based on how much (if any) of artery doesnt fill with blood containing contrast agent. extent and location of filling defect is determined

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8
Q

how does atherosclerotic plaque appear on arteriogrpahy

A

irregular or smooth

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9
Q

what will vessel occlusion look like on arteriography?

A

no filliing seen. collateral often present with long standing occlustion

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10
Q

what will a vasospasm look like on an arteriogrpahy?

A

severe narrrowing usually without occlusion

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11
Q

what will a aneursym appear on arteriography?

A

dilated artery

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12
Q

what will a fibromuscular dysplasia look like on arteriogrpahy?

A

multiple arterial stenosis caused by medial hyperplasia appearing as string of beads

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13
Q

what are limitations of arteriography?

A

may be contrasindicated in patients allergic to contrast agent or in kindey failure
inaccurate in it hemodynamic asssessmet bc of inability to provide many images in multiple planes in real time 2D is standard

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14
Q

what are complications of arteriogrpahy?

A

puncture site hematoma
pseudoany
local arterial occlusion
neurologic complications

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15
Q

what is the method for MR angiography (MRA)

A

employs radio freq energy and a strong magnetic field to produce images in multi planes
MRI instruments quantitate blood flow and construct images that look like angiogrpahym (MRA). flowing blood well distinguished from soft tissue without contrast agents

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16
Q

what are MRA limiation?

A

presence of metallic clips, pacemakers, monitoring equipment
can overestimate stenosis due to flow flow or turbulence
expensive
claustrophobia may limit some patients

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17
Q

what is interpretaton of MRA?

A

useful for AAA, dissections, peripheral artery evaluation

18
Q

what is CT method?

A

employs ionizing radiation to obtain cross sectional images of the aorta and other body structures
IV contrast allows more discrete evaluation

19
Q

what are CT limitations?

A

patient motion and presence of metal surgical clips
one plane used
limited application in PAD due to smaller vessels

20
Q

what is CT interpretation?

A

identifies size of aorta, extent and size of aneurysm

helps define relatipship of aorta to renal artery origins

21
Q

what are lifestyle modifications?

A

stop smoking
consistent exercise to enhance collateral developement
weight controle and a low cholesterold diet may enhance normal endothelial cell metabolism
protection to prevent injury and or infection to extremity of interest

22
Q

what are pharmacologic methods of treatment?

A

aspirin: an antiplatelet drug that decreases platelet aggregation resulting in decreased thrombotic activity
medications that help decrease blood viscosity
antihypertensive drugs may serve to decrease shearing forces against vessel walls

23
Q

what are some examples of antihypertensive drugs?

A 
ACE 
ARB 
beta blockers 
diurectics 
HTN meds
24
Q

what is endarterectomy?

A

surgical removal of atherosclerotic material usually includes portion of intimal lining

25
Q

what are some treatment options?

A

endarectomy

bypass grafts

26
Q

in a significant stenosis what do bypass grafts provide

A

an alternate pathway for blood to travel

27
Q

what do successful bypass grafts have>

A

good inflow, conduit, and outflow

28
Q

what are some common bypass grafts?

A 
aorta to both iliacs arteries ( only used for AAA)
aorta to bi-femoral (also used for AAA)
femoral to pop
femoral to PTA, to ATA, to peroneal \
renal artery, SMA
29
Q

what is a form of angioplasty?

A

percutaneous transluminal angioplasty (PTLA)

30
Q

what is PTLA?

A

used to dilate focal plaque formation in vessel

31
Q

what is the techq used for PTLA?

A

similar to arteriography, except a balloon tipped catherter is used
catheter tip is brought ot the region of stenosis
balloon is slowly inflated, pushing plaque against the walls of vessel, dilating artery lumen
balloon deflated catherter removed
minor discomfort

32
Q

which vessels is angioplast normal performed on?

A

renal, iliac, femoral, or pop a

33
Q

T/F angioplasty can be done on all vessels or types of lesions

A

false

performed in vessels with focal stenosis

34
Q

what percentage of complications occur with PTLA?

A

5%

2-3% require surgery or alter hospital stay

35
Q

what are some pros with PTLA?

A

minor discomfort

morbidity, mortality, cost of angioplasty are low

36
Q

what is the purpose of a stent/ stent graft?

A

to maintain intraluminal structure/ patency of artery. act as a type of scaffold

37
Q

what are some limiations with stent graft?

A

abdominal gas
inability of patient to lie flat
complications similar to those for arteriography

38
Q

what are some problems with stents?

A

restenosis due to intimal hyperplasia, stent migration, graft limb compression, twisting, dislodgement, leaks

39
Q

what vessels are stents put in?

A

AO, renal, iliac, femoral, repair of AAA with stent grafts

40
Q

what technq can stents be similar to?

A

arteriography

RVT Review (30 decks)

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