CCS Cardiovascular Treatment Procedures 4

Question 1

Which complication is most feared immediately following carotid artery stenting (CAS)?

Accepted Answer

Cerebral embolization causing stroke

Answer

Embolic stroke from plaque or thrombus dislodged during carotid stenting is the most serious procedural risk, which is why embolic protection devices are routinely used.

Question 2

In cardiac resynchronization therapy (CRT), the third lead is typically placed in the:

Accepted Answer

Coronary sinus to pace the left ventricle

Answer

The LV pacing lead is advanced through the coronary sinus into a lateral or posterolateral cardiac vein to resynchronize the left ventricle.

Question 3

A patient with a patent foramen ovale (PFO) and cryptogenic stroke is referred for closure. Which device is most commonly used for transcatheter PFO closure?

Accepted Answer

Amplatzer Septal Occluder or GORE CARDIOFORM device

Answer

Double-disk occluder devices such as the Amplatzer PFO Occluder or GORE CARDIOFORM are the standard percutaneous tools for closing PFOs.

Question 4

What is the mechanism of action of ticagrelor compared to clopidogrel in antiplatelet therapy post-PCI?

Accepted Answer

Ticagrelor reversibly binds P2Y12 without requiring hepatic activation; clopidogrel is a prodrug requiring CYP2C19

Answer

Ticagrelor directly and reversibly inhibits P2Y12 without hepatic conversion, providing faster and more consistent platelet inhibition than clopidogrel, which is a prodrug.

Question 5

Rotational atherectomy is best suited for which type of coronary lesion before stenting?

Accepted Answer

Heavily calcified coronary stenoses

Answer

The rotating diamond-tipped burr of a rotablator ablates calcified plaque, modifying the lesion to allow adequate balloon expansion and stent delivery.

(CCS) Certified Cardiovascular Specialist Practice Test

(CCS) Certified Cardiovascular Specialist Practice Test

CCS Cardiovascular Treatment Procedures 4