CCI - Cardiovascular Credentialing International Peripheral Arterial Evaluation Questions and Answers

Question 1

A 68-year-old male complains of pain in his left calf after walking two blocks, which is relieved by rest.
His right brachial pressure is 140 mmHg and his left is 136 mmHg.
Ankle pressures are 126 mmHg on the right and 82 mmHg on the left.
What is the correct interpretation of his left Ankle-Brachial Index (ABI)?

Accepted Answer

Moderate arterial disease (claudication)

Answer

Normal

Answer

Mild arterial disease

Answer

Severe arterial disease (rest pain)

Question 2

While performing a lower extremity arterial duplex exam, the technologist obtains a triphasic Doppler waveform in the common femoral artery. Distally, in the popliteal artery, the waveform is monophasic with a delayed systolic upstroke. What does this change in waveform most likely indicate?

Accepted Answer

A hemodynamically significant stenosis between the two sample sites

Answer

An arteriovenous fistula

Answer

Normal distal vasodilation after exercise

Answer

A pseudoaneurysm in the distal SFA

Question 3

A duplex ultrasound of the superficial femoral artery (SFA) reveals an area of plaque with spectral broadening and elevated velocities. The peak systolic velocity (PSV) within the stenosis is 250 cm/s. The PSV in the SFA segment just proximal to the stenosis is 100 cm/s. Based on the velocity ratio, how would this stenosis be graded?

Accepted Answer

Moderate; 50-74% stenosis

Answer

Normal; <50% stenosis

Answer

Severe; >75% stenosis

Answer

Mild; <50% stenosis

Question 4

Which of the following findings on a Pulse Volume Recording (PVR) is most consistent with hemodynamically significant arterial disease at or proximal to the level of the tracing?

Accepted Answer

A delayed upstroke, rounded peak, and loss of the dicrotic notch

Answer

A sharp systolic peak with a prominent dicrotic notch

Answer

An abnormally increased amplitude compared to the adjacent segment

Answer

A rapid systolic upstroke with a brisk downstroke

Question 5

A 55-year-old male patient presents with bilateral buttock and thigh claudication and erectile dysfunction. Physical examination reveals absent femoral pulses. These findings are most suggestive of occlusive disease in which arterial segment?

Accepted Answer

Aortoiliac segment

Answer

Popliteal arteries

Answer

Superficial femoral arteries

Answer

Tibioperoneal trunk

Question 6

A patient with suspected peripheral arterial disease is unable to perform a treadmill exercise test due to poor ambulatory status. Which alternative physiologic test can be used to induce peripheral vasodilation and assess for significant arterial disease?

Accepted Answer

Post-Occlusive Reactive Hyperemia (PORH)

Answer

Allen's Test

Answer

Thoracic Outlet Maneuver

Answer

Adson's Maneuver