VASCULAR ARDMS ACTUAL QUESTIONS AND

VASCULAR ARDMS (ACTUAL / ) QUESTIONS AND

VERIFIED ANSWERS

what will doppler demonstrate with hep v obstruction - -- Answers----a lack of flow in the hepatic veins at the site of the occlusion and collateral pathways that don't follow the usual vsculature course. A bicolor flow in the hepatic veins (one branch blue and the other red) is a good indication of proximal vein occlusion and distal patency, caudate veins enlarge greater than 3mm (specific to budd chiari in the absence of CHF)

what is a method of treating portal HTN - --Answers----TIPS- transjugular intrahepatic portosystemic shunts

what are the normal findings associated with a TIPS - -- Answers----flight protrusion of ends of shunt into portal and hepatic veins, fully filled stent, monophasic slightly pulsatile flow, moderate spectral broadening, PSV from at least 50-60 cm/sec to 90-120 cm/ sec, similar velocities at both ends, hepatopedal flow in portal, increase in portal flow comared to pre shunt status, portal velocity of at least 30 cm/sec with normal range of 37-47 cm/sec

what is a TIPS - --Answers----this is a channel created between the high pressure portal system and the low pressure hepatic veins and installed via the jugular vein

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what are the features of a TIPS stent - --Answers----metallic device used to create shunt or channel and easily visualized

what should a pre-op sonogram of a TIPS include - --Answers-- --should include documentation of flow and patency in the PV, SV, and SMV. Evaluate the liver as well. Location of hepatomas may change the plan for a shunt depending on the tumor's location

what should a post-op sonogram of a TIPS include - --Answers- ---approximately within the first 24 hours of TIPS placement, document the patency of the TIPS and establish baseline velocities

what is the most common site of a stent stenosis - --Answers-- --at the hepatic end of the shunt

how is the stenosis visualized within a TIPS - --Answers----a high velocity flow less than 50-60 cm/s is a clue the shunt is malfunctioning, flow increasing to more than 100 cm/s is indicative of stenosis

what are the positive aspects of a shunt - --Answers---- reduces ascites, prevents collateral hemorrhage, and increased quality of life

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what is the highest risk of stenosis and occlusion in a shunt within the first few weeks - --Answers----thrombus

what is the highest risk of stenosis and occlusion in a shunt later on - --Answers----neointimal hyperplasia

what do the splanching arteries supply - --Answers----the blood to the bowel

what vessels are splanching or mesenteric arteries - -- Answers----celiac, sma, ima

what is the purpose of evaluating the mesenteric arteries - -- Answers----to look for songraphic signs of mesenteric ischemia (Often prevented due to collateralization)

what are the normal velocities of the celiac arteries - -- Answers----PSV 50-160 cm/s and EDV of less than 50 cm/s

what are the normal velocities of the sma preprandial - -- Answers----110-180 cm/s

what are the normal velocities of the sma postprandial - -- Answers----broad PSV ranges

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