CCI Peripheral Arterial Evaluation 4

Question 1

A patient presents with rest pain and a non-healing ulcer on the great toe. ABI is 0.30. What Rutherford classification does this represent?

Accepted Answer

Category 5 — minor tissue loss

Answer

Rutherford Category 5 describes ischemic rest pain with minor tissue loss such as a non-healing digital ulcer.

Question 2

Which velocity criterion on duplex ultrasound best identifies a native vessel stenosis of ≥50% in the iliac artery?

Accepted Answer

PSV ratio > 2.0

Answer

A PSV ratio greater than 2.0 compared to the adjacent normal proximal segment indicates ≥50% diameter reduction in the iliac artery.

Question 3

During pulse volume recording (PVR), what does a flat or nearly absent waveform at the ankle level indicate?

Accepted Answer

Severe proximal occlusive disease

Answer

A flat PVR waveform at the ankle indicates severe reduction in pulsatile blood flow from significant proximal occlusive disease.

Question 4

What is the primary advantage of CTA over duplex ultrasound in evaluating lower extremity PAD?

Accepted Answer

Better visualization of calcified vessels and runoff anatomy

Answer

CTA provides excellent visualization of the entire arterial tree including runoff vessels, even in heavily calcified arteries, superior to duplex for planning revascularization.

Question 5

A post-stent duplex scan of the superficial femoral artery shows a PSV of 350 cm/s within the stent. What is the most appropriate interpretation?

Accepted Answer

In-stent restenosis ≥50%

Answer

An in-stent PSV greater than 300–350 cm/s with an elevated PSV ratio indicates significant in-stent restenosis of ≥50%.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Peripheral Arterial Evaluation 4