Interventional Radiology Techniques & Procedures Flashcards

Under fluoroscopy, where is the ideal common femoral artery puncture site for retrograde access?

Answer: Over the medial third of the femoral head

Puncturing over the medial femoral head places the arteriotomy in the CFA, above the bifurcation and below the inguinal ligament, where it can be compressed against bone.

A femoral puncture made above the inguinal ligament most increases the risk of which complication?

Answer: Retroperitoneal hemorrhage

Above the inguinal ligament the external iliac artery cannot be compressed effectively, so bleeding tracks into the retroperitoneum.

A 3 cm femoral pseudoaneurysm with a narrow neck is found after a procedure. What is the preferred first-line treatment?

Answer: Ultrasound-guided thrombin injection

Ultrasound-guided percutaneous thrombin injection has a high success rate and is first-line for suitable post-catheterization pseudoaneurysms.

A puncture made too low, at or below the femoral bifurcation, is most associated with which complication?

Answer: Pseudoaneurysm and arteriovenous fistula

Low punctures enter smaller vessels near the femoral vein with little bony support, which predisposes to pseudoaneurysm and AV fistula.

Before radial artery access, which test checks dual palmar circulation using pulse oximetry plethysmography?

Answer: Barbeau test

The Barbeau test uses a pulse oximeter on the thumb while the radial artery is compressed to check ulnar collateral flow.

Which medication is commonly given intra-arterially through the radial sheath to prevent radial artery spasm?

Answer: Verapamil

Calcium channel blockers such as verapamil, often with nitroglycerin and heparin, are part of the standard radial 'cocktail' to prevent spasm.

How does French sizing differ between vascular sheaths and catheters?

Answer: Sheaths refer to inner diameter; catheters refer to outer diameter

A sheath's French size is the largest catheter it accepts (inner diameter), while a catheter's French size is its outer diameter, with 1 Fr equal to about 0.33 mm.