Order Peripheral Interventional Procedures

Order Peripheral Interventional Procedures
Order 5902948
Order Peripheral Interventional Procedures
1 Which of the following patients is not an appropriate
candidate for carotid artery stenting (CAS) according
to the SAPPHIRE trial criteria?
(A) An 82-year-old woman with a recent history
of transient ischemic attack (TIA), poorly
controlled hypertension, and 60% stenosis of
the internal carotid
(B) A 72-year-old man with a history of myocardial
infarction (MI) 3 weeks ago and an 80% stenosis
of the right internal carotid artery (ICA)
(C) A 60-year-old diabetic man with a history of
cerebrovascular accident (CVA) 6 weeks ago
resulting in residual left upper extremity paresis
with 90% left internal carotid stenosis
(D) An asymptomatic 85-year-old man with severe
emphysematous lung disease, NYHA (New York
Heart Association) class III congestive heart
failure (CHF) and bilateral 80% stenosis of the
internal carotid arteries
2 All of the following are complications of CAS, except:
(A) Stroke
(B) Hypotension/Bradycardia
(C) MI
(D) Hyperperfusion Syndrome
(E) All of the above
Order Peripheral Interventional Procedures
3 The following angiogram was performed on a
74-year-old man, a diabetic patient with a recent
history of hospitalization for transient left upper extremity paresis. On the basis of the data reported by
large, randomized trials evaluating the efficacy of traditional carotid endarterectomy (CEA), which of the
following statements is true?
(A) This patient is not an appropriate candidate for
CEA because of his recent transient left upper
extremity paresis, and should be considered for
CAS for an optimum outcome
(B) The patient would be appropriate for CEA, and
can expect a lower risk of any major or fatal
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Peripheral Interventional Procedures 213
ipsilateral stroke in the 2 years following the
procedure at the expense of an initial increase in
the 30-day risk of death and stroke as compared
with medical therapy
(C) The patient is a candidate for CEA, and can expect a lower risk of stroke or death immediately
following the procedure but the benefit becomes
insignificant at 2 years as compared with medical therapy
(D) The patient is a candidate for CEA, and can
expect a lower risk of any ipsilateral or contralateral stroke in the 2 years following the procedure
4 As a part of an executive physical, a healthy 65-yearold man with a history of hypertension and tobacco
use, but no history of stroke or TIA, was referred for
a carotid ultrasound that revealed 70% and 40%
stenoses of the left and right common carotids,
respectively. On the basis of the information provided
by the multiple, randomized trials evaluating the
efficacy of CEA in patients with asymptomatic carotid
disease, which of the following statements is true?
(A) Performing CEA on the left carotid artery at
this time would likely expose the patient to
a perioperative risk of stroke, death, and MI
around 3% to 7%, and would not likely result in
a lower risk of subsequent stroke
(B) Performing CEA on the left carotid artery would
likely result in an elevated risk of perioperative
stroke, death, or MI around 3%, but would result
in a reduced incidence of ipsilateral stroke by 2
years postoperatively
(C) U.S. Food and Drug Administration (FDA) does
not approve carotid stenting for asymptomatic
patients at this time
(D) There is no randomized data suggesting a
long-term benefit of performing CEA in asymptomatic patients with carotid stenosis <80%
(E) Both B and C
5 Periprocedural stroke during carotid stenting is
most commonly attributable to distal embolization.
During which portion of the procedure are distal
embolic events most likely to occur?
(A) Wiring
(B) Predilatation
(C) Stenting
(D) Postdilatation
(E) Guide placement
Order Peripheral Interventional Procedures
6 Which of the following types of procedure has
the least detectable amount of embolization by
transcranial Doppler?
(A) Carotid stenting with filter on a wire emboli
protection device
(B) Carotid stenting with distal occlusion emboli
protection device
(C) Carotid stenting with proximal occlusion emboli protection device
(D) CEA
7 Which of the following statements regarding symptomatic peripheral arterial disease (PAD) isincorrect?
(A) Most patients participating in formal exercise
rehabilitation programs have been shown to
double their symptom-free walking period
(B) Because of their high rate of comorbid cardiovascular disease (CVD) and vascular events, all
patients with PAD should be considered to have
coronary artery disease (CAD) until proved otherwise, and initiated on drug therapy until their
low-density lipoprotein C (LDL-C) levels are
reduced to <100 mg per dL
(C) The presence of low ankle-brachial indices
(ABIs) in hypertensive patients is a predictor
of increased mortality
(D) The FDA has approved both pentoxiphylline
and clopidogrelfor the treatment of intermittent
claudication
8 All of the following are acceptable indications for
endovascular intervention to the superficial femoral
arterial lesion shown in the following figure, except:
(A) Incapacitating, intermittent claudication
(B) Rest pain
(C) Development of nonhealing ulcerations or
wounds of the lower extremity
214 900 Questions: An Interventional Cardiology Board Review
(D) Presence of a 5-cm eccentric 80% lesion of the
proximal superficial femoral artery (SFA) in a
patient with mild, intermittent claudication
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