Misc Venous

Question 1

What is the gold standard for venous testing?

Answer 1

contrast venography

the number of venograms has decreased due to the accuracy of duplex scanning

Question 2

Ascending venography is used to evaluate what?

Answer 2

acute DVT, congenital venous disease and/or anomalies, chronic venous thrombosis

Question 3

Descending venography is used primarily to detect and quantify what?

Answer 3

reversed flow from incompetent venous valves

Question 4

What are limitation of contrast venography?

Answer 4

• highly technical in technique and interpretation
• relatively expensive
• uncomfortable
• allergic reactions or extravasation of contrast media

Question 5

What is the process of ascending venography?

Answer 5

• radio-opaque contrast media injected into vein on dorsum of the foot
• serial x-rays taken as media passes through venis identifying filling defects, anatomic variations, development of collateral channels

Question 6

What is the process of descending venography?

Answer 6

• radio-opaque contrast media injected in common femoral vein
• serial x-rays taken as material passes through veins to detect and quantify reversed flow and location of incompetent valves

Question 7

What are different ways to decrease venous stasis?

Answer 7

• limit long periods of inactivity
• wear support hose
• elevate legs
• intermittent pneumatic calf compression during and after surgery

Question 8

What is the meaning of prophylaxis?

Answer 8

the preventing of disease

Question 9

What does low-doses of heparin do?

Answer 9

• interferes with formation of blood clots

- does not lyse an existing thrombus

Question 10

What pharmaceuticals are used to treat acute DVT and/or PE?

Answer 10

• heparin: loading dose followed by continuous intravenous infusion for 5-10 days
• coumadin: prescribed for three to six months
• lytic therapy: breaks down thrombus

Question 11

What is used to prevent PE in patients who cannot be anticoagulated and using fluoroscopy is placed in the IVC via jugular or femoral vein?

Answer 11

vena cava interruption devices

- an external caval clip may also be placed around the IVC during abdominal surgery to decrease risk of PE

Question 12

When is iliofemoral venous thrombectomy preformed?

Answer 12

for impending limb loss (phlegmasia cerulea dolens) if thrombolytic therapy (streptokinase or urokinase) does not dissolve clot

Question 13

What surgical treatments can be done for chronic venous insufficiency?

Answer 13

• vein ligation of incompetent perforators preformed

- valvular reconstruction or valve transplantation procedures infrequent

Question 14

Surgical treatment of varicose veins?

Answer 14

-saphenous vein removal or local excision (phlebectomy) of varicosities

Question 15

How are do endovenous procedures treat varicose veins?

Answer 15

treat from the inside using heat energy that causes the vein to shrink and slowly disappear

• major ablation types are radio frequency ablation and laser ablation
• duplex scanning utilized to confirm patency of veins; size and depth; used to follow catheter during procedure and confirm ablation and absence of thrombosis post procedure

Question 16

The process of sclerotherapy being used to treat small varicosities?

Answer 16

seals them of with sodium tetradecyl sulfate, injected into varix and compression dressing applied

Question 17

What surgical treatment creates a shunt between the portal and hepatic veins to treat portal hypertension?

Answer 17

transjugular intrahepatic portosystemuc shunt (TIPSS)

• usual approach is rt IJV to IVC into rt hepatic vein
• bridge created to portal vein
• tract stented with metallic endoprosthesis

Question 18

What are high level disinfects?

Answer 18

glutaraldehyde, cidex

hydrogen peroxide

Question 19

What are low-level disinfects?

Answer 19

quarternary ammonium
N-Alkyl T-spray II, Sani-cloth
hydrogen peroxide