2026 ARRT Vascular Interventional
Radiography Study Guide Practice Questions &
Answer Explanations Angiography Procedures
• Contrast Media • Radiation Safety • Patient
Care • Clinical Review
Section 1: Angiography Procedures (Questions 1–40)
1. Which artery is most commonly accessed for diagnostic cerebral angiography?
• A. Radial artery
• B. Femoral artery
• C. Axillary artery
• D. Popliteal artery
The femoral artery is the most common access site for cerebral
angiography due to its size, accessibility, and low complication rate. Radial
access is increasingly used but femoral remains the traditional and most
common approach.
2. The Seldinger technique is used to:
• A. Measure blood pressure
• B. Obtain percutaneous vascular access
• C. Inject contrast into joints
• D. Perform bone biopsy
The Seldinger technique involves puncturing a vessel with a needle,
passing a guidewire through the needle, removing the needle, and then
threading a catheter over the wire. It is the foundation of percutaneous
vascular access.
,3. Which catheter shape is most commonly used for selective renal
angiography?
• A. Simmons (Sidewinder)
• B. Cobra
• C. Pigtail
• D. Berenstein
The Cobra catheter is a preformed curve catheter commonly used for
selective renal, visceral, and other branch vessel catheterization due to its
ability to engage vessel ostia.
4. A pigtail catheter is primarily used for:
• A. Selective coronary angiography
• B. Flush aortography and ventriculography
• C. Subclavian artery cannulation
• D. Carotid artery stenting
The pigtail catheter has a curled tip with multiple side holes, allowing
for high-flow contrast injection and safe flushing of large vessels such as the
aorta and ventricles without causing significant recoil.
5. Digital subtraction angiography (DSA) primarily improves image quality by:
• A. Increasing radiation dose
• B. Subtracting pre-contrast images from post-contrast images
• C. Using higher contrast volume
• D. Employing larger catheters
DSA works by acquiring a mask image before contrast injection and
subtracting it from images obtained after contrast injection, thereby
removing background anatomy and enhancing visualization of contrast-
filled vessels.
,6. Which projection is best for visualizing the left main coronary artery?
• A. Right anterior oblique (RAO) caudal
• B. Left anterior oblique (LAO) caudal (Spider view)
• C. Left lateral
• D. Right anterior oblique (RAO) cranial
The LAO caudal (Spider) view is optimal for visualizing the left main
coronary artery bifurcation, including the left anterior descending and left
circumflex arteries.
7. The primary indication for carotid artery stenting is:
• A. Asymptomatic mild stenosis
• B. Symptomatic severe stenosis in high-risk surgical patients
• C. Complete carotid occlusion
• D. Carotid dissection
Carotid artery stenting is indicated for symptomatic patients with severe
stenosis (typically >70%) who are at high risk for carotid endarterectomy
due to comorbidities or anatomical factors.
8. Which of the following is a contraindication to thrombolytic therapy in acute
stroke?
• A. Onset of symptoms 2 hours ago
• B. Blood pressure 180/100 mmHg
• C. Recent intracranial hemorrhage
• D. Minor stroke symptoms
Recent intracranial hemorrhage is an absolute contraindication to
thrombolytic therapy due to the risk of catastrophic bleeding. Other
contraindications include recent surgery, uncontrolled hypertension, and
coagulopathy.
, 9. The most common complication of femoral artery access is:
• A. Infection
• B. Hematoma
• C. Arteriovenous fistula
• D. Pseudoaneurysm
Hematoma is the most common complication of femoral artery access,
occurring in up to 5% of cases. It is usually managed with manual
compression and monitoring.
10. Which vessel is catheterized for a uterine artery embolization (UAE)?
• A. Internal iliac artery → uterine artery
• B. External iliac artery → uterine artery
• C. Ovarian artery
• D. Superior mesenteric artery
UAE is performed by catheterizing the internal iliac artery and then
selectively cannulating the uterine artery, which arises from the anterior
division of the internal iliac artery.
11. A transjugular intrahepatic portosystemic shunt (TIPS) is created between
the:
• A. Portal vein and hepatic vein
• B. Hepatic artery and portal vein
• C. Inferior vena cava and portal vein
• D. Splenic vein and renal vein
TIPS creates a connection between the portal vein (usually the right or
middle hepatic vein branch) and a hepatic vein, reducing portal
hypertension.
Radiography Study Guide Practice Questions &
Answer Explanations Angiography Procedures
• Contrast Media • Radiation Safety • Patient
Care • Clinical Review
Section 1: Angiography Procedures (Questions 1–40)
1. Which artery is most commonly accessed for diagnostic cerebral angiography?
• A. Radial artery
• B. Femoral artery
• C. Axillary artery
• D. Popliteal artery
The femoral artery is the most common access site for cerebral
angiography due to its size, accessibility, and low complication rate. Radial
access is increasingly used but femoral remains the traditional and most
common approach.
2. The Seldinger technique is used to:
• A. Measure blood pressure
• B. Obtain percutaneous vascular access
• C. Inject contrast into joints
• D. Perform bone biopsy
The Seldinger technique involves puncturing a vessel with a needle,
passing a guidewire through the needle, removing the needle, and then
threading a catheter over the wire. It is the foundation of percutaneous
vascular access.
,3. Which catheter shape is most commonly used for selective renal
angiography?
• A. Simmons (Sidewinder)
• B. Cobra
• C. Pigtail
• D. Berenstein
The Cobra catheter is a preformed curve catheter commonly used for
selective renal, visceral, and other branch vessel catheterization due to its
ability to engage vessel ostia.
4. A pigtail catheter is primarily used for:
• A. Selective coronary angiography
• B. Flush aortography and ventriculography
• C. Subclavian artery cannulation
• D. Carotid artery stenting
The pigtail catheter has a curled tip with multiple side holes, allowing
for high-flow contrast injection and safe flushing of large vessels such as the
aorta and ventricles without causing significant recoil.
5. Digital subtraction angiography (DSA) primarily improves image quality by:
• A. Increasing radiation dose
• B. Subtracting pre-contrast images from post-contrast images
• C. Using higher contrast volume
• D. Employing larger catheters
DSA works by acquiring a mask image before contrast injection and
subtracting it from images obtained after contrast injection, thereby
removing background anatomy and enhancing visualization of contrast-
filled vessels.
,6. Which projection is best for visualizing the left main coronary artery?
• A. Right anterior oblique (RAO) caudal
• B. Left anterior oblique (LAO) caudal (Spider view)
• C. Left lateral
• D. Right anterior oblique (RAO) cranial
The LAO caudal (Spider) view is optimal for visualizing the left main
coronary artery bifurcation, including the left anterior descending and left
circumflex arteries.
7. The primary indication for carotid artery stenting is:
• A. Asymptomatic mild stenosis
• B. Symptomatic severe stenosis in high-risk surgical patients
• C. Complete carotid occlusion
• D. Carotid dissection
Carotid artery stenting is indicated for symptomatic patients with severe
stenosis (typically >70%) who are at high risk for carotid endarterectomy
due to comorbidities or anatomical factors.
8. Which of the following is a contraindication to thrombolytic therapy in acute
stroke?
• A. Onset of symptoms 2 hours ago
• B. Blood pressure 180/100 mmHg
• C. Recent intracranial hemorrhage
• D. Minor stroke symptoms
Recent intracranial hemorrhage is an absolute contraindication to
thrombolytic therapy due to the risk of catastrophic bleeding. Other
contraindications include recent surgery, uncontrolled hypertension, and
coagulopathy.
, 9. The most common complication of femoral artery access is:
• A. Infection
• B. Hematoma
• C. Arteriovenous fistula
• D. Pseudoaneurysm
Hematoma is the most common complication of femoral artery access,
occurring in up to 5% of cases. It is usually managed with manual
compression and monitoring.
10. Which vessel is catheterized for a uterine artery embolization (UAE)?
• A. Internal iliac artery → uterine artery
• B. External iliac artery → uterine artery
• C. Ovarian artery
• D. Superior mesenteric artery
UAE is performed by catheterizing the internal iliac artery and then
selectively cannulating the uterine artery, which arises from the anterior
division of the internal iliac artery.
11. A transjugular intrahepatic portosystemic shunt (TIPS) is created between
the:
• A. Portal vein and hepatic vein
• B. Hepatic artery and portal vein
• C. Inferior vena cava and portal vein
• D. Splenic vein and renal vein
TIPS creates a connection between the portal vein (usually the right or
middle hepatic vein branch) and a hepatic vein, reducing portal
hypertension.
