FRCR FRCR Interventional Radiology 2 — Questions and Answers
Question 1: Which complication is most feared after hepatic arterial chemoembolization?
- Post-embolization syndrome (Correct answer)
- Hepatic artery thrombosis
- Biloma formation
- Pulmonary embolism
Correct answer: Post-embolization syndrome
Post-embolization syndrome (fever, pain, nausea) is the most common complication after TACE, though hepatic abscess and non-target embolization are most feared serious complications.
Question 2: In inferior vena cava filter placement, what is the preferred infrarenal placement position?
- Below the renal veins to preserve renal vein drainage (Correct answer)
- Above the renal veins
- At the level of the iliac confluence
- At the cavoatrial junction
Correct answer: Below the renal veins to preserve renal vein drainage
Infrarenal placement preserves renal vein drainage and avoids caval thrombosis that would compromise renal function.
Question 3: Absolute contraindication to thrombolysis in acute limb ischemia includes:
- Recent stroke within 2 months (Correct answer)
- Peripheral artery disease
- Mild renal impairment
- Age over 70 years
Correct answer: Recent stroke within 2 months
Recent stroke within 2 months is an absolute contraindication to catheter-directed thrombolysis due to the high risk of intracranial hemorrhage.
Question 4: Radiofrequency ablation (RFA) of liver tumors causes cell death primarily through:
- Thermal coagulation necrosis from resistive heating (Correct answer)
- Cryogenic ice-ball formation
- Irreversible electroporation
- Microwave cavitation
Correct answer: Thermal coagulation necrosis from resistive heating
RFA applies alternating current that causes ionic agitation and frictional resistive heating, producing coagulative necrosis at temperatures above 60°C.
Question 5: Which angiographic finding is pathognomonic of active gastrointestinal hemorrhage?
- Extravasation of contrast into the bowel lumen (Correct answer)
- Arteriovenous fistula
- Pseudoaneurysm
- Vessel cutoff sign
Correct answer: Extravasation of contrast into the bowel lumen
Active contrast extravasation pooling in the bowel lumen during mesenteric angiography directly identifies the bleeding point and guides embolization.
Question 6: The BRTO (Balloon-occluded Retrograde Transvenous Obliteration) procedure is used to treat:
- Gastric varices via the left gastric or gastrorenal shunt (Correct answer)
- Esophageal varices
- Hepatic vein stenosis
- Portal vein thrombosis
Correct answer: Gastric varices via the left gastric or gastrorenal shunt
BRTO occludes the draining shunt (typically gastrorenal) and injects sclerosant retrograde to obliterate gastric varices that are poorly treated by TIPS alone.
FRCR FRCR Interventional Radiology 2
Which complication is most feared after hepatic arterial chemoembolization?