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