CCI Peripheral Arterial Evaluation 3

Question 1

A patient with diabetes has non-compressible ankle vessels on ABI testing. Which alternative measurement is most appropriate?

Accepted Answer

Toe-brachial index

Answer

The toe-brachial index (TBI) is the preferred alternative because digital arteries are rarely calcified in diabetic patients.

Question 2

During exercise ABI testing, a patient's ABI drops from 0.85 at rest to 0.52 immediately after treadmill walking. What does this indicate?

Accepted Answer

Hemodynamically significant arterial stenosis

Answer

A post-exercise ABI drop of ≥20% or to below 0.90 confirms hemodynamically significant PAD not apparent at rest.

Question 3

Which artery is the most common site of atherosclerotic occlusion in the lower extremity?

Accepted Answer

Superficial femoral artery at the adductor canal

Answer

The superficial femoral artery at the adductor (Hunter's) canal is the most common site of lower extremity atherosclerotic occlusion.

Question 4

What is the significance of a high-thigh pressure that is lower than the brachial pressure in segmental limb pressure testing?

Accepted Answer

Suggests aortoiliac occlusive disease

Answer

A high-thigh pressure lower than brachial pressure indicates inflow disease at the aortoiliac level.

Question 5

On a lower extremity duplex scan, color flow imaging shows aliasing at a focal arterial segment. What is the primary cause of aliasing?

Accepted Answer

Velocity exceeding the Nyquist limit

Answer

Aliasing occurs when blood flow velocity exceeds the Nyquist limit (half the pulse repetition frequency), causing color wraparound.

CCI - Cardiovascular Credentialing International Practice Test