Podcast
Questions and Answers
Which artery is the most common site of upper extremity stenosis?
Which artery is the most common site of upper extremity stenosis?
- Axillary artery
- Radial artery
- Ulnar artery
- Brachial artery (correct)
What is the most common treatment for subclavian steal syndrome?
What is the most common treatment for subclavian steal syndrome?
- Carotid endarterectomy
- Angioplasty of vertebral artery
- Thrombolytic therapy
- Covered stent to subclavian artery (correct)
In thoracic outlet syndrome, which structure passes over the 1st rib anterior to the anterior scalene muscle?
In thoracic outlet syndrome, which structure passes over the 1st rib anterior to the anterior scalene muscle?
- Subclavian vein (correct)
- Brachial plexus
- Subclavian artery
- Axillary vein
What is the most likely consequence of proximal subclavian artery stenosis in subclavian steal syndrome?
What is the most likely consequence of proximal subclavian artery stenosis in subclavian steal syndrome?
What is the most common complication of aneurysms above the inguinal ligament?
What is the most common complication of aneurysms above the inguinal ligament?
What are the most common complications of aneurysms below the inguinal ligament?
What are the most common complications of aneurysms below the inguinal ligament?
Which risk factor is associated with visceral artery aneurysms?
Which risk factor is associated with visceral artery aneurysms?
When should splenic artery aneurysms be repaired?
When should splenic artery aneurysms be repaired?
What is the primary association of popliteal artery aneurysms?
What is the primary association of popliteal artery aneurysms?
What are the surgical indications for popliteal aneurysms?
What are the surgical indications for popliteal aneurysms?
"What is a common cause of pseudoaneurysms in the femoral artery?"
"What is a common cause of pseudoaneurysms in the femoral artery?"
What is the primary treatment for fibromuscular dysplasia affecting the renal artery?
What is the primary treatment for fibromuscular dysplasia affecting the renal artery?
What is the primary consequence of Buerger’s disease?
What is the primary consequence of Buerger’s disease?
What characterizes Marfan’s disease?
What characterizes Marfan’s disease?
Where is the right internal jugular site preferred for dialysis catheter placement?
Where is the right internal jugular site preferred for dialysis catheter placement?
What is the ideal diameter for a Cimino fistula at 6 weeks?
What is the ideal diameter for a Cimino fistula at 6 weeks?
How is venous obstruction commonly attributed to A-V fistula/graft failure?
How is venous obstruction commonly attributed to A-V fistula/graft failure?
What is the initial diagnostic modality for identifying inflow/outflow/anastomosis problems in a fistula?
What is the initial diagnostic modality for identifying inflow/outflow/anastomosis problems in a fistula?
How are arterial inflow issues such as subclavian stenosis typically treated?
How are arterial inflow issues such as subclavian stenosis typically treated?
What is the recommended treatment for venous outflow issues caused by venous hyperplasia?
What is the recommended treatment for venous outflow issues caused by venous hyperplasia?
What is the recommended approach to control bleeding from a graft/fistula?
What is the recommended approach to control bleeding from a graft/fistula?
Which symptoms are associated with venous insufficiency?
Which symptoms are associated with venous insufficiency?
What is the recommended treatment for superficial thrombophlebitis?
What is the recommended treatment for superficial thrombophlebitis?
Where is deep venous thrombosis (DVT) most commonly found?
Where is deep venous thrombosis (DVT) most commonly found?
What are the mainstays of treatment for venous insufficiency?
What are the mainstays of treatment for venous insufficiency?
How are acquired A-V fistulas typically managed?
How are acquired A-V fistulas typically managed?
What is the primary cause of pain in thoracic outlet syndrome?
What is the primary cause of pain in thoracic outlet syndrome?
How is subclavian vein compression diagnosed?
How is subclavian vein compression diagnosed?
What is the characteristic symptom of mesenteric vein thrombosis?
What is the characteristic symptom of mesenteric vein thrombosis?
How is nonocclusive mesenteric ischemia (NOMI) managed?
How is nonocclusive mesenteric ischemia (NOMI) managed?
What causes median arcuate ligament syndrome?
What causes median arcuate ligament syndrome?
What imaging modality is used to diagnose chronic mesenteric angina?
What imaging modality is used to diagnose chronic mesenteric angina?
What is the recommended treatment for SMA embolism?
What is the recommended treatment for SMA embolism?
How is cervical ribs related to thoracic outlet syndrome diagnosed?
How is cervical ribs related to thoracic outlet syndrome diagnosed?
What can result from subclavian artery compression caused by weight lifting?
What can result from subclavian artery compression caused by weight lifting?
What is the characteristic symptom of SMA thrombosis?
What is the characteristic symptom of SMA thrombosis?
Study Notes
Vascular and Neurologic Disorders of the Thoracic Outlet
- Phrenic nerve runs on top of anterior scalene muscle and can cause back, neck, arm, and/or hand pain/weakness/tingling/numbness
- Cervical spine and chest MRI are used to diagnose thoracic outlet syndrome (TOS), with cervical ribs being the number one anatomic abnormality
- Brachial plexus irritation, often due to cervical rib, is the primary cause of pain in TOS
- Subclavian vein compression, usually due to anterior scalene hypertrophy, can lead to effort-induced thrombosis, with venography being the gold standard for diagnosis
- Subclavian artery compression, often caused by weight lifting, can result in hand pain from ischemia, and is diagnosed using duplex U/S or angiogram
- Mesenteric ischemia, with a high mortality rate, is commonly caused by embolic or thrombotic occlusion, and nonocclusive mesenteric ischemia (NOMI) is associated with low cardiac output states
- SMA embolism typically occurs 2–10 cm distal to the origin of the SMA, and requires open embolectomy, with planned 2nd look laparotomy being recommended
- SMA thrombosis presents with similar symptoms to embolism, often at the SMA ostium, and is treated with thrombectomy and resection of infarcted bowel
- Mesenteric vein thrombosis is characterized by subacute bloody diarrhea and crampy abdominal pain, and is diagnosed using abdominal CTA with venous phase
- Nonocclusive mesenteric ischemia (NOMI) is associated with critically ill patients and low cardiac output, and is managed by volume resuscitation and improving cardiac output
- Median arcuate ligament syndrome causes celiac artery compression, leading to chronic pain and weight loss, and is treated with transecting the median arcuate ligament
- Chronic mesenteric angina presents with visceral angina after meals, and is diagnosed using CTA and managed with PTA and stent or bypass if necessary
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Test your knowledge about the most common complications and risk factors associated with visceral, peripheral, and splanchnic artery aneurysms.
