Vascular Registry CCI Exam Review With 100% Correct Answers 2023

Vascular Registry CCI Exam Review With 100% Correct Answers 2023 Abdominal Aorta waveform(s) Low resistance proximal, Higher resistance beyond renals Celiac Artery supplies Liver, spleen, stomach, & proximal small bowel Branches of the Abdominal AO 1st major-Celiac artery (trunk/axis) 2nd major-SMA Renals 3rd major-IMA (after renals) Celiac Axis Branches into Common Hepatic (to right), Splenic, & Left Gastric (off left) Common Hepatic Arteries Gives rise to the Gastroduodenal artery in PANC head & divides into Rt & Lt Hepatics Splenic Artery Branches left and posteriosuperior to PANC body/tail SMA/IMA waveforms High resistance preprandial/Low resistance postprandial SMA supplies Bowel from duodenum to prox small bowel IMA supplies Bowel descending & rectosigmoid colon Right Renal Artery Branches anterolateral, posterior to IVC Left Renal Artery Branches posterolateral Renal Artery waveform Low resistance Portal vein is usually formed by the confluence of SMV & Splenic veins *It also receives blood from the inferior mesenteric, gastric, and cystic veins Portals walls/waveforma echogenic walls & phasic waveforms Renal veins are formed by renal tributaries Left Renal Vein Longer than Rt.; Receives suprarenal/Gonadal vein Left Renal pathway Anterior to AO; Posterior to SMA Right Renal Vein No tributaries; shorter Hepatic Veins Hepatofugal flow; from liver to IVC Patient status for Abdominal Vascular Imaging NPO 8-12 hours Ectasia Local diameter increase with small bulge (20% increase for Ao 3cm) AAA growth rate 1-2mm/year until 3-4cm; 5 mm/yr 4cm Aneurysm classification 2-3cm; 3-4cm for AAA AAA Intervention 5.5cm (high risk for rupture-catastrophic) Fusiform Concentric enlargement; All 3 layers intact Saccular Eccentric enlargement; All 3 layers compromised; Less common (1%); Usually in Thoracic Ao Types of Saccular AAA 1-Cannula Placement 2-Mycotic aneurysm (bacterial infection Ao wall) 3-Vasculitis (Inflammatory process) 4-Penetrating ulcer rupture into media Vasculitis/Aortitis Inflammatory process in wall of Ao beginning with outer (adventitia) layer and moving inward; ie: Takayasu's Dissection Intimal wall compromised resulting in 2 lumens falsetrue; flow reversal Type 1 (a/b) endoleak Leak in anastamosis of graft at (a) prox or (b) distal end Type 2 endoleak Aorta branch vessel; exhibits retrograde flow; more dangerous b/c internally bleeding Type 3/4 endoleak (3) Junction of modular components; (4) Trans graft flow-graft defect Chronic Mesenteric Ischemia "Fear of Food" 95% of Bowel Ischemia cases Atherosclerotic stenosis/occlusion in main mesenteric arteries: 70% stenosis in 2/3 of principle mesenteric arteries Ischemia diagnosis criteria via Moneta Celiac 200cm/s SMA 275cm/s Median Arcuate Ligament Syndrome (MALS) Arch impedes on Celiac during EXPIRATION (non-compressed during inhalation) Measurement(s) of Splenic Vein 7-17 cm long; 5-10mm diameter Portal vein diameter 13mm Blood supply to liver 75% from Portal VEIN; 25% from Hepatic ARTERY