Order Atherectomy Rotablation and Laser

Order Atherectomy Rotablation and Laser
Order 5956002
Order Atherectomy Rotablation and Laser
1 Which of the following best describes results from
directional coronary atherectomy (DCA)?
(A) ‘‘Optimal’’ atherectomy with use of intravascular ultrasound to guide the extent of atherectomy does not result in lower restenosis rates
compared with historical controls
(B) The mechanism of lumen enlargement following directional atherectomy occurs both by
tissue extraction and by vessel stretching
(C) Recovery of deep wall elements (media and
adventitia) correlates with the incidence of
restenosis
(D) Restenosis following directional atherectomy
occurs because of positive remodeling and
intimal proliferation
2 Which of the following patients would be most likely
to have a complication during directional atherectomy?
(A) A 50-year-old woman with a focal mid right
coronary artery (RCA) lesion with a reference
vessel size of 3.5 mm
(B) An 80-year-old man with tortuous calcified iliac
arteries and a calcified mid circumflex lesion
with reference vessel size of 2.5 mm
(C) A 70-year-old man with prior coronary artery
bypass grafting and an ostial lesion of the
saphenous vein graft (SVG) to a diagonal vessel
with a reference diameter of 3.5 mm
(D) A 60-year-old man with restenosis of the mid
left anterior descending (LAD) coronary artery
with a reference segment of 3.5 mm
3 Randomized clinical trials of directional atherectomy
versus balloon angioplasty for de novo lesions in
native coronary arteries found which of the following
comparing atherectomy with angioplasty?
(A) Lower complication rates, lower restenosis
(B) Lower complications rates, higher restenosis
(C) Higher complication rates, lower restenosis
(D) Higher complication rates, higher restenosis
4 Which of the following is most likely to cause a
complication during directional atherectomy?
(A) Use of a 0.014-in. guidewire with polytetrafluoroethylene (PTFE) coating the distal portion of
the wire
(B) Clockwise rotation and deep seating of a guide
catheter to achieve a stable working platform
(C) Limiting device balloon inflation pressures to
40 psi or less
(D) Placing the guidewire tip 3 to 5 cm distal to
device in the straight portion of target artery
5 A 64-year-old man is referred for DCA of the lesion
shown (left figure). After the initial pass, the cutter
could not be backed out over the guidewire (right
figure). The angiogram following removal of the
DCA device and guidewire is shown (middle figure).
A B C
135
Order Atherectomy Rotablation and Laser
136 900 Questions: An Interventional Cardiology Board Review
Which of the following is most likely responsible for
this finding?
(A) Overaggressive wire manipulation during initial
wiring of the lesion
(B) Use of a nitinol wire
(C) Distal migration of the guidewire with guidewire
tip rotation
(D) Limiting DCA to four to six passes before
removing device
6 Which one of the following is best treated with
rotational atherectomy?
(A) Presence of visible thrombus
(B) Lesions >20 mm in length
(C) Recent angioplasty with evidence of localized
dissection
(D) Severely angulated lesion
7 Which of the following is true with respect to
rotational atherectomy and restenosis?
(A) When compared with balloon angioplasty in
randomized clinical trials, restenosis is lower
with rotational atherectomy
(B) Restenosis is lower with rotational atherectomy
in small vessels compared with balloon angioplasty
(C) Adjunctive use of rotational atherectomy before
coronary stenting is associated with lower
restenosis rates compared with use of stenting
alone
(D) No randomized clinical trial has shown reduced
restenosis rates with rotational atherectomy
8 Which of the following is most likely to be associated
with ‘‘slow flow’’ or ‘‘no reflow’’ during rotational
atherectomy?
(A) Burr runs ≤1 minute in duration
(B) Burr speeds of 140,000 to 160,000 rpm
(C) Multiple burr runs <1 minute apart
(D) ‘‘Deceleration’’ <5,000 rpm
9 Which of the following is most likely to lead to
potential complications during rotational atherectomy?
(A) Differential cutting
(B) Orthogonal displacement of friction
(C) Wire bias
(D) Microparticulate debris <12 µm
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