interventionalradiologyflash

Question 1

‘Most common arch anomaly ‘

Answer 1

‘Left arch with aberrant right subclavian artery. 2% of population.’

Question 2

‘Two congenital aorta arch anomalies seen in an adult vascular radiology practice:’

Answer 2

‘Left-sided (normal) arch with aberrant right subclavian artery. Pseudocoarctation (aortic kink) of thoracic aorta.’

Question 3

‘Diverticulum of Kommerell?’

Answer 3

‘Dilation at origin of aberrant right subclavian artery. May impress esophagus

Question 4

‘Pseudocoarctation (aortic kink)?’

Answer 4

‘Mild form of coarctation

Question 5

‘Traumatic aortic injury sites’

Answer 5

‘Proximal ascending aorta. Just beyond left subclavian (aortic isthmus). Just above the level of the diaphragm.’

Question 6

‘Evidence of mediastinal hemorrhage includes’

Answer 6

‘Poorly defined fat planes. Mediastinal hemorrhage. Perivascular hematoma. Periaortic hematoma. Contrast extravasation.’

Question 7

‘Direct signs of aortic injury include’

Answer 7

‘Abnormal contour of aorta. Change in caliber. Intraluminal irregularity (intimal flap).’

Question 8

‘Keys to distinguishing a ductus bump from a contour abnormality at the aortic isthmus?’

Answer 8

‘Ductus bump is very smooth and convex without acute margins. Aortic tear has acute margins and irregularly shaped. May have associated Luminal narrowing. Persistence of contrast in the outpouching. Double densities. Intimal flap.’

Question 9

‘Ascending aortic aneurysm causes:’

Answer 9

‘Cystic medial necrosis. Marfan syndrome. Ehlers-Danlos syndrome. Syphilis.’

Question 10

‘Aneurysms of the arch and descending aorta

Answer 10

causes:’

Question 11

‘Posttraumatic thoracic aortic aneurysms most often occur at’

Answer 11

‘Aortic isthmus.’

Question 12

‘Major complications of thoracic aortic aneurysms’

Answer 12

‘Rupture. Acute dissection.’

Question 13

‘Takayasu arteritis’

Answer 13

‘Granulomatous (giant cell) inflammation of media and adventitia of large elastic arteries. IAsian women. Female-to-male ratio of 10:1. Most often affects thoracic aorta and its proximal branches and pulmonary arteries.’

Question 14

‘Aortic infection is usually divided into two types based on the causative microorganism:’

Answer 14

‘Syphilitic. Mycotic (nonsyphilitic).’

Question 15

‘Mycotic nonsyphilitic aortitis

Answer 15

the most common organisms are:’

Question 16

‘Very large aneurysmal aortic root with sinotubular ectasia (tulip bulb appearance)’

Answer 16

‘Marfan syndrome.’

Question 17

‘Stanford classification for aortic dissection?’

Answer 17

‘Type A involves ascending aorta. Type B does not involve ascending aorta.’

Question 18

‘Differential diagnosis of aortic dissection ‘

Answer 18

‘Intramural hematoma. Penetrating aortic ulcer. Together these constitute the acute aortic syndrome.’

Question 19

‘Diagnosis of chronic PE by pulmonary angiography is based on the identification of’

Answer 19

‘Webs. Luminal irregularities. Abrupt vessel narrowing and/or obstruction. Dilated central pulmonary arteries.’

Question 20

‘Most common complaint in symptomatic patients with PAVM’

Answer 20

‘Epistaxis from hereditary hemorrhagic telangiectasia.’

Question 21

‘PAVMs categories’

Answer 21

‘Simple: One artery to one vein. Complex: Multiple feeding arteries and/or draining veins.’

Question 22

‘Indications for transcatheter embolotherapy of PAVMs include’

Answer 22

‘Exercise intolerance. Prevention of neurologic complications. Prevention of lung hemorrhage (hemoptysis).’

Question 23

‘PAVMs are usually treated when the feeding artery is at least’

Answer 23

‘3 mm in size.’

Question 24

‘Most common indication for bronchial arteriography ‘

Answer 24

‘Hemoptysis.’

Question 25

'Common anatomic variants of peripheral arterial system. '

Answer 25

'Absence of anterior or posterior tibial arteries (5% of individuals). High origin of radial artery from the axillary or brachial artery (17% of patients). Persistent sciatic artery (normal fetal branch of internal iliac artery that continues into lower etremity).'

Question 26

'In general

Answer 26

a normal ABI should be greater than'

Question 27

'An ABI between _____ and _____ signifies intermittent to severe claudication.'

Answer 27

' 0.95 and 0.5 '

Question 28

'The angiographic appearance of diabetic vascular disease differs from typical atherosclerosis in two main ways:'

Answer 28

'Vascular calcification involving arteries of all sizes. Disease involvement is more distal

Question 29

'Most common site for upper-extremity atherosclerotic involvement is the'

Answer 29

'Proximal left subclavian artery. Can result in subclavian steal.'

Question 30

'In acute peripheral thrombosis or embolism

Answer 30

what clinical findings steer toward an endovascular approach versus open surgery.'

Question 31

'Exclusive of Takayasu arteritis

Answer 31

what two main vasculitides occur in the peripheral arterial system?'

Question 32

'Giant cell arteritis typically involves the'

Answer 32

'Medium to large blood vessels supplying head (Temporal arteries)

Question 33

'Angiographic hallmark of Buerger disease is'

Answer 33

'Corkscrew appearance of arteries. Collaterals around areas of occlusion (most often at wrists and ankles). Absence of atherosclerotic findings.'

Question 34

'Buerger disease (thromboangiitis obliterans)'

Answer 34

'Acute inflammation and thrombosis of arteries and veins. Primarily affects hands and feet. Typically young heaving smoking males. '

Question 35

'Range of angiographic findings of trauma include'

Answer 35

'Vasospasm. Intimal irregularity. Pseudoaneurysm. Extravasation. Arteriovenous fistula.'

Question 36

'Hypothenar hammer'

Answer 36

'Repetitive palmar trauma. Injury of ulnar artery adjacent to hook of hamate. Ulnar artery can be aneurysm

Question 37

'Which peripheral arteries can be sacrificed (embolized) without consequence?'

Answer 37

'Branches of internal iliac. Branches of profunda femoris. Geniculate branches. Subclavian/axillary/brachial artery branches (except vertebral). '

Question 38

'Fibromuscular disease (FMD) has been described in what arteries'

Answer 38

'Upper extremity: Subclavian artery. Axillary artery. Brachial artery. Lower extremity: Iliac artery. Femoral artery. Popliteal artery. '

Question 39

'Thoracic outlet syndrome'

Answer 39

'Compression syndrome of upper limb neurovascular bundle at the level of scalene muscles and first rib. 70% with arterial injury have a cervical rib.'

Question 40

'Popliteal entrapment'

Answer 40

'Popliteal artery and or vein deviate around medial head of gastrocnemius.'

Question 41

'Adventitial cystic disease'

Answer 41

'Mucin collects in adventitial layer. May lead to narrowing or obstruction. Most commonly in popliteal artery.'

Question 42

'Arteriomegaly'

Answer 42

'Unusual manifestation of aneurysmal disease. Diffuse

Question 43

'Elective repair of an asymptomatic AAA is when the diameter exceeds'

Answer 43

'5.0 cm.'

Question 44

'Endoleaks are categorized into four types:'

Answer 44

'Type 1: Leak at superior or inferior attachment site. Type 2: Patent side branch filling grafted aneurysm sac (Lumbar or Inferior mesenteric artery). Type 3: Loss of stent graft integrity. Type 4: Leak through porous graft material.'

Question 45

'Commonest pathogen of mycotic aneurysms or pseudoaneurysms of abdominal aorta?'

Answer 45

'Salmonella species

Question 46

'Leriche syndrome'

Answer 46

'Bilateral buttock claudication

Question 47

'Aortoiliac occlusive disease can be caused by inflammatory diseases

Answer 47

in particular'

Question 48

'Hypoplastic aortic syndrome'

Answer 48

'Congenital long segment narrowing of aorta. Usually seen in young females.'

Question 49

'There are a number of etiologies for renal artery occlusive disease

Answer 49

including'

Question 50

'Neurofibromatosis causes renal artery stenosis by'

Answer 50

'Extrinsic compression of renal artery by neurofibromata. Disorganized intimal and medial proliferation at renal artery orifice or proximal renal artery.'

Question 51

'Hypertension secondary to neurofibromatosis is seen mainly in'

Answer 51

'Children.'

Question 52

'Renal artery aneurysms

Answer 52

outside of trauma

Question 53

'PAN is a rare necrotizing vasculitis that affects small and medium-sized arteries of multiple organs

Answer 53

most commonly'

Question 54

'Differential diagnosis of microaneurysms includes'

Answer 54

'PAN. Wegener granulomatosis. Systemic lupus erythematosus. Rheumatoid vasculitis. Drug abuse.'

Question 55

'most common aneurysm outside of aorta and iliac arteries.'

Answer 55

'Splenic artery aneurysm.'

Question 56

'Hepatic neoplasms (mets included)

Answer 56

which are responsive to embolization?'

Question 57

'Tumor replacement of greater than _____% of normal liver is a contraindication to embolization.'

Answer 57

' 50% to 75%.'

Question 58

'three collateral communications of mesenteric arteries.'

Answer 58

'Marginal artery of Drummond: Anastomosis between right colic

Question 59

'Causes of acute mesenteric ischemia.'

Answer 59

'Arterial embolism and thrombosis. Nonocclusive ischemia. Mesenteric venous thrombosis.'

Question 60

'A left SVC occurs in 0.3% of the population and descends through the left mediastinum anteriorly to join the _______

Answer 60

which drains into the RA'

Question 61

'Azygos continuation of the IVC is caused by'

Answer 61

'Absence of intrahepatic portion of the IVC. Failure of right subcardinal vein to anastomose with hepatic veins. Hepatic veins drain into RA. Renal and iliac veins drain via azygos and hemiazygos veins into SVC.'

Question 62

'Retroaortic left renal vein

Answer 62

circumaortic left renal vein?'

Question 63

'The femoral vein is a continuation of the popliteal vein at the ______.'

Answer 63

'Adductor hiatus'

Question 64

'Contraindications for peripheral thrombolysis: '

Answer 64

'Internal bleeding. Stroke within past 6 months. Cranial or spinal surgery within past 2 months. Intracranial neoplasm. Bleeding diathesis. Uncontrolled hypertension. Contraindication to anticoagulation.'

Question 65

'Complications of venous thrombolysis include:'

Answer 65

'Pulmonary embolus. Bleeding: At access site. Hemorrhagic stroke. GI bleeding. Retroperitoneal hematoma. '

Question 66

'Phlegmasia cerulea dolens'

Answer 66

'Limb arterial compromise caused by massive acute venous thrombosis. Thrombosis involves both main and collateral venous drainage. Causes swelling and severe elevations in vascular resistance resulting in ischemia.'

Question 67

'Paget-von Schrötter syndrome'

Answer 67

'Compression of subclavian vein by a cervical rib

Question 68

'SVC syndrome is caused by'

Answer 68

'SVC stenosis and or thrombosis. Extrinsic compression: Bronchogenic carcinoma (up to 82%). Granulomas (histoplasmosis and tuberculosis). Lymphoma. Intrinsic: Intravascular foreign bodies (pacemaker leads

Question 69

'May-Thurner syndrome'

Answer 69

'Compression of left iliac vein by crossing right iliac artery. This is normal anatomy. Arterial pressure on vein results in wall thickening

Question 70

'Budd-Chiari syndrome'

Answer 70

'Occlusion of hepatic veins. Result of hepatic venous or IVC outflow obstruction.'

Question 71

'Coronary vein portosystemic shunt pathway'

Answer 71

'Communicates with azygos system in submucosa of distal esophagus and gastric cardia.'

Question 72

'Contraindications to TIPS'

Answer 72

'Hepatic failure. Severe right heart failure.'