PREPARATION PACK 2026
◉ True or False: When we expand a balloon we are resetting the
muscle fiber memory so that it believes that the over expansion is
normal. Answer: True
◉ How long does it generally take for a coronary artery to
"remember" their old muscle fiber memory and try to go back to it's
regular size? Answer: 31-180 days
◉ Why were stents invented? Answer: To prevent coronary artery
muscle fibers from returning to their old muscle fiber size between
31-180 days
◉ What starts the clotting cascade in coronary arteries? Answer:
When endothelial cells are knocked off and the muscle fiber is
exposed.
◉ Is this stent full apposed? Answer: This stent is fully apposed
◉ Is this stent full apposed? Answer: This stent is not fully apposed
,◉ Is this stent full apposed? Answer: This stent is not fully apposed
◉ Is this stent full apposed? Answer: This stent is not fully apposed
◉ Is this stent full apposed? Answer: This stent is fully apposed
◉ What is layer 1 on this image? Answer: Adventitia
◉ What is layer 2 on this image? Answer: Media
◉ What is layer 3 on this image? Answer: Intima
◉ What is layer 4 on this image? Answer: lumen
◉ Identify the structures on this IVUS image from left to right.
Answer: adventitia, media, intima, and catheter.
◉ What is "A" in this IVUS image? Answer: Catheter
◉ What is "B" in this IVUS image? Answer: Intima or true lumen
,◉ What is "C" in this image? Answer: Thrombus/ blood behind the
flap
◉ What is "D" in this image? Answer: D is the flap or dissection.
◉ What is an eccentric plaque? Answer: Plaque that only covers part
of the diameter of the artery.
◉ What is concentric plaque? Answer: Plaque that covers all the way
around the artery.
◉ What is the clotting cascade? Answer: Series of chemical reactions
involving 12 plasma clotting factors that lead to final conversion of
fibrinogen into a stabilized fibrin mesh with the purpose of
controlling bleeding.
◉ How are platelets activated? Answer: Platelets are not activated
until they stick to the collagen on the muscle fiber of the coronary
artery. This sends a message to the liver to release the first clotting
factor.
◉ What does the 1st factor, Von Willebrand factor do in the clotting
cascade? Where is it release? Answer: VWF is released by the liver.
It's job is to make sure that the platelets sticks to the muscle fiber.
, ◉ What is released right after the Von Willebrand factor? What is its
purpose? Answer: Factor VIII. it's job is to make sure that the
platelets stick even better than VWF, but it cannot be released by the
liver until after the VWF.
◉ After VWF, and factor VIII are released, what is released next?
Answer: The body will release calcium, and the liver will release
arachidonic acid.
◉ What does arachidonic acid do? Answer: Goes to the platelets
allowing it to stick even more tightly. Cannot be released until after
VIII.
◉ Why do patients take aspirin (ASA) during a heart attack?
Answer: It blocks the action of arachidonic acid. The platelets are
not able to stick to the muscle fibers. As a person is having a heart
attack they can continue to make clots. The ASA will continue to
prevent the action of arachidonic acid and help prevent the
formation of more clots.
Typically we tell patients that it makes the platelets less sticky.
◉ After the action of arachidonic acid is reported back to the liver,
what does the liver release? Answer: ADP Adenosine diphosphate