Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

65 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
Angio complications
puncture site – hematoma, AVF, pseudoaneurysm, thrombosis, infection; contrast – renal failure, allergic reaction; catheter-related – thromboembolism, stroke, dissection; therapy-related – hemorrhage
high flow with sideholes for central vessels, low flow with endhole for selective vessels, higher flow rate with shorter catheter and larger diameter; pigtail – aorta, PA; Cobra – mesenteric, renal, contralateral iliac; Simmons – mesenteric, arch vessels; Tracker – coaxial subselection; straight – runoff.
Flow rates
abd aorta/PA 20/40; celiac/SMA 6/60; renals 5/15; IMA 2/20; pelvis 10/40; one leg runoff 4/48; arch 30/60; CCA 8/10; ICA 6/8; ECA 2/4; vertebral 6/8; IVC 15/45.
145 standard length, 0.018-0.038 inch, Newton J, Rosen, Amplatz, Bentson, Glide.
vasodilator – papaverine 25-50 mg/hr for mesenteric ischemia, contraindicated with complete AV block; NTG 100 ug for peripheral spasm; vasoconstrictor – vasopressin 0.2-0.4 U/min for GI bleeding, contraindicated with CAD, HTN, arrhythmia.
indications – hemorrhage (GI, varices, traumatic organ, bronchial artery, tumor, post-op), vascular (AVM, AVF, pseudoaneurysm), pre-op devascularization (RCC, AVM, vascular bone mets), hepatic chemoembolization (palliative, gelfoam + ethiodol + chemotherapy for HCC, metastatic neuroendocrine tumor); beware of collaterals, use Tracker if possible; temporary agents – gelfoam pledgets (for UGIB, pelvic trauma, post-op); permanent agents – steel coils (large vessel, aneurysm, tumor), PVA (small particles for distal occlusion, tumors, bilateral UFE for fibroids), ethanol (solid organ necrosis, peripheral AVM); Cx – postembolization syndrome, infection, nontarget embolization
indications – arterial graft thrombosis, native acute thrombosis, prior to percutaneous intervention, hemodialysis AVF or graft, venous thrombosis; absolute contraindications – active bleed, intracranial lesion (stroke, tumor, recent surgery), pregnant, nonviable limb; favorable prognosis if recent clot, good inflow/outflow, positioned in thrombus; endpoints – no lysis after 12 hours infusion, major complications, fibrinogen <100mg/dl; always treat underlying lesions; TPA 0.5-1 mg/hr and heparinize, repeat angio in 12 hrs, coaxial dual infusion; success 90% for grafts and 75% for native; Cx – major hemorrhage, distal embolization, pericatheter thrombosis
indications – claudication or rest pain, tissue loss, nonhealing wound, establish inflow for distal bypass graft, hemodialysis AVF or grafts; measure pressure gradients before and after PTA, heparinize after lesion crossed; priscoline 25 mg IA for vasospasm; balloon sized to adjacent normal artery except in aorta want to undersize, wire should always remain across lesion; large vessels/proximal lesions > small vessel/distal, stenoses > occlusions, short stenoses > long, isolated disease > multifocal, good inflow/outflow > poor; success for fem/pop PTA is 90% initial and 70% at 5 yrs, renals 95% initial with 95% at 5 yrs for FMD and 70-90% for atherosclerosis, ostial lesions poor prognosis; Cx – groin cx, distal embolization, rupture, renal infarction or failure.
indications – unsuccessful PTA, recurrent stenosis, venous obstruction/thrombosis, TIPS, long segment stenosis, total occlusion, ineffective or unsuccessful PTA (residual stenosis > 30%, residual pressure gradient > 5 mmHg, large post-PTA dissection flap, hard calcified plaque), recurrent stenosis after PTA, ulcerated plaque, renal ostial lesions; success in iliac >90% 5 yr patency.
indications – portal HTN and variceal bleeding failed sclerotherapy, refractory ascites, Budd-Chiari, pretransplant; absolute contraindications – severe R heart failure, liver failure; relative – PV thrombosis, hepatic encephalopathy, infection, vascular liver tumors, polycystic liver dz; check PV patency, preprocedure paracentesis may be helpful; goal – portosystemic gradient < 10 mmHg, decompression of varices; patency 50% at 1 yr; Cx – hepatic encephalopathy, bleeding, shunt thrombosis or stenosis, R heart failure, renal failure; isolated gastric fundal varices from splenic vein thrombosis not indication for TIPS.
Foreign body retrieval
snare, basket, retractable forceps; if in heart use pigtail to get out of heart then snare.
premedication for contrast allergy – solumedrol 200mg IV + Benadryl 50mg PO or prednisone 40mg 16,8,2 hrs prior + Benadryl 50mg PO 1 hr prior; conscious sedation – Versed 0.5mg, Fentanyl 50 ug increments.
Coagulation correction
heparin – stop for 3-6 hrs prior, or protamine IV in minutes; coumadin – vit K x 3 takes days, or FFP in minutes; aspirin – stop aspirin 1 wk, or plts in minutes
Thoracic aortic aneurysm
atherosclerosis – 90% fusiform, desc aorta more common, rupture uncommon if <5cm; cystic medial necrosis – HTN, Marfan, Ehlers-Danlos, sinus of valsalva aneurysm (tulip bulb) asc aorta, dissection common, calcs rare; syphilis – asymmetric, saccular, tree bark calcs common; mycotic – most are saccular at asc aorta or isthmus, perianeurysmal inflammation, immunocompromised, IVDA, endocarditis, postsurgical; posttraumatic pseudoaneurysm; aortitis – Takayasu’s, giant cell arteritis, CVD; true aneurysm usu fusiform, false aneurysms (posttraumatic, mycotic, postsurgical) usu saccular.
Aortic dissection
chest or back pain, aortic insufficiency, BP discrepancy between extremities; causes – HTN, Marfan, Ehlers-Danlos, coarctation, bicuspid valve, pregnancy, trauma; Stanford A – asc aortic involvement, surgical tx, beware of pericardial tamponade, coronary artery occlusion, aortic insufficiency; Stanford B – desc aorta only, medical tx; intimal flap, displaced aortic calcs, delayed opacification of false lumen, compression of true lumen by false lumen, occlusion of branch vessels, abnormal catheter position; false lumen larger and slower flow and anterolateral in asc aorta and posterolateral in desc aorta.
Traumatic aortic injury
aortic isthmus 95%, aortic root, hiatus; CXR – wide mediastinum, loss of aortic contour, L apical cap, NGT displaced to R, L bronchus displaced down, high rib fxs, hemothorax; CT – any mediastinal hematoma should get angio; angio – intimal tear (linear filling defect, irregularity of aortic contour), pseudoaneurysm, ductus diverticulum is smooth and broad-based.
Takayasu’s arteritis
most pts < 30 and females, stenoses of arch vessels most common, stenosis and occlusion of aorta, thickening of aortic wall, PA involvement in 50%, abd aortic coarctation and RAS, aneurysms.
Giant cell arteritis
older pts > 50, dx by bx temporal artery, involves ECA branches, aorta and proximal brachiocephalic branches usu spared; subclavian, axillary, brachial involvement in 15%.
90% intrarenal, >3cm, increased risk or rupture when >5cm, assoc with popliteal aneurysms; Cx – rupture, aortocaval fistula, aortoenteric fistula, distal embolization, infection.
type 2 most common, filling of aneurysmal sac via IMA or lumbar branches.
Abdominal aortic coarctation
young adults or children; congenital – coarctation, Williams syndrome, rubella, NF; acquired – Mid aortic syndrome, Takayasu’s, FMD, radiation; segmental most common, usu involves renal arteries.
Williams syndrome
supravalvular aortic stenosis, peripheral PA stenosis, diffuse coarctation of abdominal aorta and stenosis of visceral branches.
Aortoiliac occlusive disease
Leriche syndrome in men – buttocks claudication, impotence, decreased femoral pulses; collaterals – internal mammary -> EIA via sup and inf epigastrics, IMA -> IIA via hemorrhoidal, intercostal/lumbar -> EIA via deep circumflex iliac, intercostal/lumbar -> IIA via iliolumbar and gluteals.
Mesenteric collaterals
celiac to SMA – arc of Buehler, pancreaticoduodenal arcade; SMA to IMA – middle colic -> L colic, arc of Riolan, marginal artery of Drummond; IMA to IIA – via superior hemorrhoidal; rectal arcades – superior rectal from IMA, middle rectal from IIA, inferior rectal from pudendal.
Median arcuate ligament syndrome
occlusion of proximal celiac artery from median arcuate ligament, accentuated on expiration, best detected on lateral projection.
gastritis most common, PUD, varices, MW tear; LGA > GDA; tx – vasopressin, gelfoam, PVA or coils for major arterial injury; rich collateral supply.
diverticulosis most common, angiodysplasia, colon CA, polyps, IBD, rectal dz; blood pool study for screening; inject SMA, IMA, celiac; tx – gelfoam, vasopressin, coils (used less due to less collaterals); vasopressin 0.2 U/min x 20 min, repeat angio, 0.4 U/min x 20 min if still bleeding, repeat angio, embolization or surgery if still bleeding, when bleeding controlled slow taper over 24 hrs.
Mesenteric ischemia
acute or chronic, nonocclusive most common – atherosclerosis and low flow state, arterial occlusion (embolus, thrombus, dissection, vasculitis), mechanical (hernia, volvulus, intussusception); filling defects or occlusion, diffuse vasospasm; tx – thrombolysis if acute and no bowel ischemia, surgery if bowel ischemia, nonocclusive use papaverine IA 25-50 mg/hr.
cecum/R colon, vascular tuft on antimesenteric border, early or persistent draining vein, active bleeding usu not seen.
Portal HTN
wedge – IVC pressure > 5mmHg; causes – PV thrombosis, Schistosomiasis, cirrhosis, Budd-Chiari, HV or IVC occlusion, AVM; collaterals – gastroesophageal, mesenteric, perisplenic, periumbilical, hemorrhoids; ascites, splenomegaly, portal collaterals (cavernous transformation), recanalized periumbilical vein or hepatofugal flow.
PV thrombosis
idiopathic, HCC, panc CA, mets, post-op, coagulopathies, sepsis, pancreatitis, cirrhosis and portal HTN
HV thrombosis, tumor growth in HV and/or IVC (RCC, HCC, adrenal); spider web hepatic veins, IVC narrowing, stretched straight hepatic arteries.
atherosclerosis > FMD, Neurofibromatosis, arteritis (Takayasu’s, PAN, abd aortic coarctation); atherosclerosis – older pts, usu involves proximal artery, ostial stenosis poor PTA response (50%), mid RA stenosis 80% response, PTA to control HTN or preserve renal function; FMD – medial fibroplasia most common followed by perimedial fibroplasia, medial hyperplasia, medial dissection, intimal fibroplasia, adventitial fibroplasia..., mid and distal renal > ICA or vertebrals, string of beads, excellent response to PTA, most common cause of RAS in children, spontaneous RA dissection.
RA aneursym
FMD and atherosclerosis common, NF, AML, LAM; intraparenchymal – PAN, speed kidney.
children – dehydration, sepsis, maternal DM, Wilms; adults – membranous glomerulonephritis, CVD, DM, trauma, thrombophlebitis, RCC.
PA gram
indications – PE, PAH, pseudoaneurysm (trauma or iatrogenic, tx coils), AVM (assoc with OWR, feeding artery draining vein, tx coils); pacer required if LBBB, measure PA pressures (nl PAsys<30mmHg); Cx – acute R heart failure, arrhythmia, death, no absolute contraindications; PE indications – intermediate or indeterminate VQ scan, low prob with high clinical suspicion, contraindication to anticoagulation; acute PE – intraluminal filling defect, tram-tracking of contrast, abrupt cutoff, missing vessels, no collaterals; chronic PE – eccentric filling defects (muralized), smooth cutoffs, missing vessels, synechia or webs, collaterals
Bronchial artery
indications – hemoptysis (TB, CF, CA); arise from T4-T7 posterolaterally; embolize with gelfoam, PVA, coils; Cx – spinal artery injury, pain.
LE atherosclerotic occlusive dz
sx – pain, pallor, pulselessness, paresthesias, paralysis; usu symmetric at bifurcations, SFA > iliac > tibial > pop > CFA; significant stenosis - >50% narrowing, collaterals, gradient > 10mmHg.
LE atherosclerotic aneurysmal dz
pop a most common, bilateral in 50%, assoc with AAA; pop > iliac > femoral; distal embolization and/or thrombosis.
Arterial thomboembolism
cardiac mural thrombus (LV aneurysm, afib, MI), aneurysms, iatrogenic, paradoxical (DVT and R-L shunt); emboli usu lodge at bifurcations, no collaterals, filling defects with menisci.
Buerger’s dz
thromboangiitis obliterans, male smoker 20-40 y/o, claudication, calf and foot vessels most common, abrupt segmental arterial occlusions, multiple corkscrew collaterals.
Popliteal artery entrapment
young athletes, narrowing or occlusion on plantar flexion.
May-Thurner syndrome
R common iliac artery compresses L common iliac vein -> DVT
IVC filters
contraindication or failure or complication of anticoagulation; Bird’s nest for mega cava > 28mm up to 40mm, Meditech, Simon nitinol may be placed via brachial vein; IVC gram to document patency and level of renal veins; place below renal veins; suprarenal if infrarenal clot or pregnancy with IVC compression; duplication IVCs may need filter in each; retroaortic or circumaortic LRV – place below most inferior renal vein; if no room infrarenal, can do bilateral iliac vein filters.
UE dz
atherosclerosis, vasculitis, emboli, trauma, iatrogenic, radiation, thoracic outlet syndrome – compression of brachial plexus or subclavian vessels, seen with hyperabduction, may see subtle subclavian artery aneurysm, tx is surgical if mechanical compression (e.g. cervical rib)
any trauma with abnormal pulse exam; all pts with posterior knee dislocations should get arteriography.
Hypothenar hammer syndrome
occlusion or pseudoaneurysm formation of ulnar artery as it crosses over hamate from repetitive trauma, can result in distal embolic occlusions, Raynaud’s phenomenon, improves with priscoline.
Subclavian steal syndrome
narrowed or occluded subclavian artery proximal to origin of vertebral, retrograde flow in vertebral, more common in L, caused by atherosclerosis (#1), also trauma, aneurysm, embolism, thoracic outlet syndrome, vasculitis, extrinsic tumor compression, radiation, congenital anomalies, most are asx but can get vertebrobasilar insufficiency or arm claudication.
atherosclerosis – abd aorta most common, desc thoracic aorta, peripheral vasculature (popliteal > iliac > femoral); infection (mycotic) – bacterial, syphilus; inflammation – Takayasu’s, giant cell arteritis, polyarteritis nodosa; congenital – Marfan, Ehlers-Danlos, FMD, NF
arterial – dissection, embolus, thrombosis, thrombosed aneurysm, vasculitis, extrinsic compression, drugs; venous – thrombosis (phlegmasia cerulea dolens); low flow – hypovolemia, shock, hypoperfusion
Peripheral vascular disease
atherosclerosis (occlusive, aneurysmal, small vessel in diabetics), embolic disease (thromboembolic, cholesterol emboli, plaque emboli), vasculitis, Buerger’s disease, medication
cardiac emboli – atrial fibrilliation, recent acute MI, ventricular aneurysm, bacterial endocarditis, cardiac tumor (myxoma); atherosclerotic emboli – aortoiliac plaque, aneurysm (AAA, popliteal); paradoxical emboli (R-L shunt) – DVT
Angiographic tumor features
BEDPAN – blush, encasement of arteries, displacement of arteries, puddling of contrast, arteriovenous shunting, neovascularity
Hypervascular lesions
AVM – early draining vein, no mass effect; extensive collaterals – no early draining vein, no mass effect; tumor neovascularity – early draining vein in AV shunting, mass effect from tumor
Aortic enlargement
aneurysm, dissection, poststenotic dilatation due to turbulence (coarctation, aortic valvular disease, sinus of valsalva aneurysm)
Aortic stenosis
congenital – coarctation, pseudocoarctation, Williams syndrome (supravalvular aortic stenosis), rubella syndrome; aortitis – Takayasu’s disease (most common aortitis to cause stenosis); neurofibromatosis; radiation
Pulmonary artery stenosis
Williams syndrome (infantile hypercalcemia), rubella syndrome, Takayasu’s, associated with CHD (esp tetralogy)
Hyperreninemic HTN
decreased renal perfusion – atherosclerosis, FMD; renin-secreting tumors; renal compression – large intrarenal mass (cysts, tumors), subcapsular hemorrhage (Page kidney)
Renal tumors
RCC – 80% hypervascular, neovascularity, AV shunting, parasitization; AML – aneurysms, fat content; oncocytoma – spoke wheel in 30%, most hypovascular
Renal arterial aneurysm
main artery aneurysm – FMD (common), atherosclerosis (common), NF, mycotic, trauma, congenital; distal intrarenal aneurysms – PAN, IVDA (septic), vasculitis (Wegener’s, CVD), traumatic pseudoaneurysm, radiation, amphetamine abuse (speed kidney)
Replaced hepatics
Left hepatic from left gastric. Right hepatic from the SMA.
Thoracic outlet syndrome
Paget Schroetter syndrome
Evaluate both arms
Up and down position
Complications of Fem bypass graft
Femoral Steal
Ansatamostic pseudoaneyrysms
Anastomotic stenosis
Pulmonoary AVM
Osler Weber Rendu also known as Hereditary hemorrhagic telangectasia.