Post-Test Questions

Article One (239–248)

1. Which of the following imaging modalities CANNOT provide an accurate assessment of aneurysm sac size enlargement on routine surveillance?

   • Contrast enhanced CT angiography

   • Time resolved MR angiography

   • X-ray

   • Contrast enhanced ultrasonography

   • Unenhanced CT angiography

2. Which of the following modifi cations will NOT reduce radiation exposure during CT assessment for endoleak?

   • Employing iterative reconstruction algorithm

   • Reduction in beam kVp

   • Creating “virtual unenhanced” images using dual energy CT

   • Shortening interval time between surveillance imaging

   • Reduction in tube current

3. Which of the following type of endoleak is associated with heavy atherosclerotic burden at attachment sites of EVAR grafts?

   • Type I

   • Type II

   • Type III

   • Type IV

   • Type V

   Article Two (249–258)

4. What factors may infl uence the treatment strategy of ruptured aortic aneurysms?

   • Patient comorbidities.

   • Aortic aneurysm anatomy.

   • Physician and institutional experience.

   • All of the above.

5. Which of the following statements is true?

   • Randomized, controlled trials have demonstrated a clear survival benefit of EVAR over open surgical repair in the treatment of ruptured AAA.

   • Published data demonstrates that obtaining a CTA prior to endovascular repair signifi cantly delays treatment.

   • Data are still needed to evaluate long-term outcomes of endovascular repair of ruptured AAA and TAA.

   • Rates of endovascular repair for ruptured AAA and TAA have remained relatively steady over the past decade.

6. Which of the following is not an important component for a successful endovascular program in treating ruptured aortic aneurysms?

   • A rigid formulaic approach that does not permit adaptation to new information.

   • The ability to rapidly evaluate the vascular anatomy including aortic diameter, proximal and distal landing zones, angulation, calcification and vasculature required for device delivery.

   • Cooperation among interventional radiology, vascular surgery and cardiothoracic teams.

   • A flexible approach with back-up plan that incorporates and adapts to information obtained before and during the procedure.

   Article Three (259–264)

7. Which of the following is the most commonly accepted indication for intervention of type II endoleaks?

   • All type II endoleaks necessitate urgent intervention

   • Aneurysm sac growth

   • High flow velocities within the aneurysm sac

   • Greater than 3 infl ow or outfl ow vessels

   • Poorly defi ned infl ow vessels on CTA

8. What is the preferred initial endovascular method for addressing type I endoleaks?

   • Balloon angioplasty

   • Bare metal stent placement

   • Extension cuff placement

   • Endoanchor placement

   • n-BCA or Onyx embolization

9. Which of the following is the preferred approach for treatment of a persistent type II endoleak supplied by the inferior mesenteric artery status-post prior transarterial embolization?

   • Repeat transarterial embolization

   • Translumbar embolization

   • Transcaval embolization

   • Transabdominal embolization

   • Laparoscopic ligation of the IMA

   Article Four (265–271)

10. Which of these is critical to evaluate during preoperative planning for TEVAR?

    • Proximal landing zone

    • Aortic tortuosity

    • Size of the access vessels

    • Location of branch vessels

    • All of the above

11. Which of these is not a contraindication to coverage of the left subclavian artery without revascularization?

    • Patent LIMA coronary graft from prior CABG

    • Occluded right vertebral artery with dominant left vertebral artery

    • Left arm AV fi stula being used for dialysis.

    • Right subclavian artery stenosis

12. Of the following, which would not be an appropriate option for management of a type I endoleak?

    • Continue surveillance as these will usually thrombose with time

    • Extend the graft proximally, covering the left subclavian artery if needed

    • Perform a hybrid repair with aortic arch debranching, carotid-subclavian bypass, and proximal extension of TEVAR

    • Balloon the proximal endograft to attempt to achieve better seal

    Article Five (272–277)

13. What is the most frequent complication following EVAR?

    • Aneurysm rupture

    • Renal failure

    • Type 1 endoleak

    • Caudal margin of femoral head

    • Type 2 endoleak

14. Which anatomic factor is associated with the highest risk of developing a type 2 endoleak following EVAR?

    • Patent lumbar arteries.

    • Larger aneurysm sac size

    • Patent inferior mesenteric artery

    • Mural thrombus greater than 50%

15. What is the most appropriate initial management of type 1 endoleak?

    • Repeat endovascular stenting

    • Open repair

    • Observation and close imaging surveillance

    • Improve blood pressure management

    Article Six (278–288)

16. What does PEVAR stand for?

    • Primary EndoVascular abdominal aortic Aneurysm Repair

    • Parallel technique for EndoVascular aortic Aneurysm Repair

    • Percutaneous EndoVascular abdominal aortic Aneurysm Repair

    • Percutaneous EndologixdeVice Aneurysm Repair

17. The “preclose” technique requires how many PercloseProGlide devices per groin accessed?

    • One

    • Two

    • Three

    • Four

18. The PercloseProGlide device is FDA-approved for use in all PEVAR cases, regardless of device manufacturer.

    • True

    • False

    Article Seven (289–303)

19. What aortic aneurysm characteristic would be considered hostile?

    • Aortic aneurysm neck length >10 mm

    • Aortic aneurysm neck diameter <30 mm

    • Neck angle >60 degrees

    • HCircumferential calcifi cation >50%

20. What is the fi rst endovascular staple device to obtain FDA-approval for clinical use?

    • InTact Vascular's Tack-it endovascular stapler.

    • HeliFx's Aortic EndoAnchor

    • Gore's Excluding endostapler

    • Medtronic Tag-it endostapler

21. In which direction and orientation (relative to the aortic stent graft) do standard snorkel endografts travel?

    • Caudal, inside the aortic stent graft

    • Caudal, outside the aortic stent graft

    • Cranial, inside the aortic stent graft

    • Cranial, outside the aortic stent graft

    Article Eight (304–310)

22. Of the listed devices, which is currently approved for use in the United States by the FDA?

    • EndologixVentana device

    • Cook Zenith p-branch device

    • Cook Zenith fenestrated stent graft

    • Anaconda fenestrated stent graft

23. Internal iliac artery hypoperfusion can result in which of the following?

    • Buttock claudication

    • Colonic ischemia

    • Impotence

    • All of the above

24. What aneurysmal characteristics are problematic for traditional endovascular abdominal aortic aneurysm repair (EVAR)?

    • Neck angulation

    • Coverage of the internal iliac artery

    • Inclusion of mesenteric vessels

    • All of the above