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PVI > Extremity Arterial > Flashcards

Extremity Arterial Flashcards

1
Q

no duplicated brachial artery

A

high brachial bifurcation into radial and ulnar arteries

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2
Q

distribution in diabetes

A

tibioperoneal trunk

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3
Q

distibution in non diabetics

A

distal SFA or bifurcation

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4
Q

arterial ulceration dry gangrene

A

foot/toes

irregular

shallow

minimal/no bleeding poor granulation

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5
Q

venous ulceration wet gangrene

A

medial malleolus

deep irregular shape

round edges

mild/moderate pain

granulating base

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6
Q

irregular ulcers

A

venous

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7
Q

shallow ulcers

A

arterial

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8
Q

granulating ulcers

A

venous

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9
Q

characteristics of ischemic rest pain

A

at night with foot elevated relieved by dangling foot or walking

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10
Q

waveform prior to stenosis

A

peaked -

monophasic -

high resistance

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11
Q

waveform distal to stenosis

A

parvus et tardus

monophasic

low resistance

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12
Q

hyperemic flow

A

all above baseline

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13
Q

ABI predicts severity in absence of calcified vessels

A

not reliable with calcified vessels

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14
Q

significant ABI change = 0.15

A

increasing severity of disease

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15
Q

ABI > 0.5

A

single level disease

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16
Q

ABI

A

multilevel disease

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17
Q

claudication

A

0.5 - 0.9

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18
Q

rest pain

A

0.25 - 0.5

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19
Q

normal ABI

A

0.9 - 1.3 (other chart 0.96 - 1.3)

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20
Q

mild disease ABI

A

0.80-0.94 (other chart 0.85-0.95)

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21
Q

ABI moderate disease

A

0.50 - 0.79 (other chart 0.51- 0.84)

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22
Q

ABI severe disease

A

0.30 - 0.49 (other chart 0.25 - 0.50)

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23
Q

ABI critical

A
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24
Q

falsely high pressures

A

due to medial calcification in diabetes and CRF

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25
Q

if greater than 15 mm difference btw PT and DP

A

proximal disease

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26
Q

effects on PVR amplitude

A

stroke volume

blood pressure

vasomotor tone

blood volume

limb size limb position

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27
Q

prosthetic graft normal velocity & velocity ratio

A
28
Q

prosthetic graft moderate stenosis

A

180-300 cm/sec ratio > 2

29
Q

prosthetic graft high grade stenosis

A

PSV > 300 cm/sec

ratio > 3.5

30
Q

impending prosthetic graft failure

A

PSV

31
Q

vein graft normal velocity

A

> 45 cm/sec ratio

32
Q

vein graft moderate stenosis

A

250-300 cm/sec

ratio > 3.0

33
Q

vein graft high grade stenosis

A

> 350 cm/sec

ratio > 3.6

34
Q

prior femoropopliteal endovascular intervention > 50% stenosis

A

> 180 cm/sec

ratio > 2.5

35
Q

prior femoropopliteal endovascular intervention > 70% stenosis

A

> 300 cm/sec

36
Q

in stent > 50% restenosis of SFA

A

PSV > 190 cm/sec ratio > 1.5

37
Q

in stent > 80% restenosis of SFA

A

PSV > 275 cm/sec ratio > 3.5

38
Q

graft flow velocity

A

average of peak systolic velocities from 3-4 nonstenotic graft segments

normally between 40-45 cm/sec

can be less with larger grafts

39
Q

monphasic bypass graft waveform

A

inflow tract obstruction

40
Q

staccato waveform - no diastolic flow

A

distal anastomotic or outflow obstruction

41
Q

exercise recovery

A

15 min severe occlusive disease

42
Q

% pressure decrease post exercise - normal range

A

17-34%

43
Q

% pressure decrease post exercise single level disease

A

35-50%

44
Q

% pressure decrease post exercise multi level disease

A

> 50%

45
Q

Takayasu’s arteritis

A

aorta and branches usually dilation and aneurysm females usually ages 20-40

46
Q

Giant cell arteritis (temporal arteritis)

A

medium/large size vessels temporal artery and ECA branches 75-85 year old (women)

47
Q

Kawasaki’s disease

A

small medium arteries including coronaries age 2-5 years

48
Q

elevated celiac artery velocity

A

exclude median arcuate syndrome record PSV after deep inspiration if normalizes, then confirms diagnosis

49
Q

fasting SMA waveform

A

like triphasic arterial waveform

50
Q

non fasting SMA waveform

A

low resistance, slow acceleration/deceleration continuous diastolic forward flow

51
Q

retrograde common hepatic artery waveform

A

suggestive of celiac stenosis or occlusion

52
Q

normal celiac artery velocity

A

98-105 cm/sec

53
Q

normal SMA velocity

A

97-142 cm/sec

54
Q

normal IMA velocity

A

93-189 cm/sec

55
Q

Bernoulli principle

A

decrease area results in increased velocity increased velocity decreases pressure area inc - velocity dec - pressure inc

56
Q

longer stenosis

A

smaller velocities

57
Q

Reynolds number threshold

A

2000 normal 2000-4000 transitional > 4000 turbulence

58
Q

before stenosis at or just past stenosis after stenosis

A

increased PSV - decreased pressure post stenotic turbulence parvus tardus

59
Q

cuff bladder *** what percentage of limb diameter

A

40% limb circumference or 20% of limb diameter

60
Q

going distally in leg pressure and velocity change

A

pressure increases and velocity decreases

61
Q

exacerbation of popliteal entrapment

A

leg hyperextension

dorsiflexion and plantar flexion

62
Q

arteritis with concentric narrowing

A

Takayasu and giant cell arteritis

63
Q

UE arterial index normal pressure normal

A

0.8 >

70 mm Hg

64
Q

medium vessel arteritis

A

Kawasaki

Behcet

Churg

Strauss

Polyarteritis nodosa

65
Q

large vessel arteritis

A

Takayasu

giant cell

66
Q

small vessel arteritis

A

wegener Henoch schonlein purpua cryroglobulemia microscopic polyangitis SLE RA

PVI (9 decks)

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