RVT Post-Intervention and Grafts 5

Question 1

After ultrasound-guided thrombin injection for pseudoaneurysm treatment, which finding confirms successful occlusion?

Accepted Answer

Complete absence of flow within the pseudoaneurysm sac on color and spectral Doppler

Answer

Successful thrombin injection is confirmed by the complete absence of Doppler-detectable flow within the entire pseudoaneurysm sac immediately after injection.

Question 2

During graft surveillance, an elevated velocity is found only at the distal anastomosis. B-mode imaging shows intimal hyperplasia at the toe of the anastomosis. What is the expected long-term natural history if untreated?

Accepted Answer

Progressive stenosis likely leading to graft thrombosis within months to years

Answer

Distal anastomotic intimal hyperplasia is a progressive lesion that, if left untreated, typically leads to high-grade stenosis and eventual graft thrombosis.

Question 3

On duplex evaluation after iliac artery stenting, which finding is MOST suggestive of in-stent restenosis rather than external compression?

Accepted Answer

Focal PSV elevation within the stent with normal velocities immediately proximal and distal

Answer

In-stent restenosis produces focal velocity elevation confined to the intraluminal stenosis, with velocity normalization proximal and distal to the lesion.

Question 4

A patient with a reversed saphenous vein graft undergoes duplex 2 years postoperatively. A valve cusp remnant is identified causing turbulent flow with a PSV ratio of 1.8. What is the recommended management?

Accepted Answer

Close interval surveillance (every 3 months) to monitor for progression, with referral if ratio exceeds 2.0

Answer

A PSV ratio of 1.8 at a valve site does not yet meet the >2.0 threshold for intervention but warrants shortened surveillance intervals to detect progression.

Question 5

When evaluating a composite sequential bypass graft (vein proximally, PTFE distally with distal vein cuff), where is the HIGHEST risk location for stenosis development?

Accepted Answer

The vein-to-PTFE anastomosis and the distal vein cuff-to-native artery anastomosis

Answer

Composite graft failure is most common at the synthetic-to-vein junction and the distal anastomosis where intimal hyperplasia preferentially develops at material transitions and anastomotic sites.

(RVT) Registered Vascular Technologist Practice Test

(RVT) Registered Vascular Technologist Practice Test

RVT Post-Intervention and Grafts 5