Order Cerebrovascular Interventions Discussion

Order Cerebrovascular Interventions Discussion
Order 5980213
Order Cerebrovascular Interventions Discussion
All the following statements pertaining to strokes are
true, except:
(A) Of all strokes, 88% are ischemic in etiology and
12% are hemorrhagic
(B) When on aspirin, the risk of stroke in an asymptomatic patient with carotid stenosis 60%
(C) Among patients with symptomatic carotid
disease (those with prior transient ischemic
attack [TIA] or strokes), the risk of recurrence
is approximately 30% to 35% at 5 years
(D) Half of the men older than the age of 75 years
have carotid atherosclerosis with stenosis over
50% detected in >30% of cases by ultrasound
2 In assessing carotid artery atherosclerosis, all the
following statements are true, except:
Order Cerebrovascular Interventions Discussion
(A) When performed by a trained sonographer, the
sensitivity and specificity of Doppler ultrasonography and B-mode imaging approaches 90%
accuracy compared with angiography
(B) Peak end-diastolic velocity above 135 cm per
second and peak end-systolic velocity above
240 cm per second are suggestive of stenosis
>80%
(C) Carotid duplex scans are very useful in assessing
near complete occlusive lesions
(D) Contrast-enhanced magnetic resonance angiography is superior to carotid duplex in assessing
long internal carotid lesions (>3 cm)
(E) Angiography should be used when the results
of the noninvasive tests are inconclusive, yield
conflicting results and/or if percutaneous intervention is planned
3 The following are true, except:
(A) In the Aspirin in Carotid Endarterectomy (ACE)
trial, high dose aspirin (650 to 1000 mg per
day) was superior to low dose aspirin (75 to
325 mg per day) in reducing the risk of stroke,
myocardial infarction (MI), or death at 30 and
90 daysfollowing carotid endarterectomy (CEA)
(B) In the Clopidogrel versus Aspirin in Patients
at Risk for Ischemia Events (CAPRIE) trial,
clopidogrel (75 mg per day) was not superior to
aspirin (325 mg) in reducing the risk of stroke,
MI, or vascular death
(C) In the Clopidogrel in Unstable angina to prevent
Recurrent Events (CURE) trial, which included
12,562 patients with acute coronary syndrome,
the combination of aspirin and clopidogrel
(when compared with aspirin alone) resulted
in a 20% relative risk reduction of stroke, MI,
or vascular death
(D) In the physician health study (a primary
prevention study of 22,071 patients), aspirin
(325 mg per day) resulted in 10% relative risk
reduction of ischemic stroke
4 The following render CEA difficult or not feasible,
except:
(A) Prior radiation to the neck or previous radical
neck surgery
(B) Severe tandem lesion
(C) Aorto-ostial or proximal common carotid artery
lesion
(D) Lesion location is distal cervical (C2 level and
above)
225
226 900 Questions: An Interventional Cardiology Board Review
5 The advantages of the PercuSurge Balloon distal
embolization protection device when compared with
filter devices include the following, except:
(A) Mimics standard guide wires more than other
filters
(B) Ability to cross severe lesions
(C) Particles of all sizes can be blocked
(D) Easier to use than most filters
6 A 59-year-old woman with a history of coronary
artery disease and prior left CEA presented with
a history of two episodes of slurred speech and
right-sided weakness. These episodes lasted for 75
(B) Female sex
(C) Number of stents used
(D) Diabetes
8 The following are considered high-risk factors during
CAS, but stenting is still considered feasible,except in:
(A) Age >75
(B) Type-3 aortic arch
(C) Pedunculated thrombus
(D) Stenosis involving the ostium of the internal
carotid artery (ICA)
9 In patients with vertebrobasilar insufficiency, the
following are true, except:
(A) The data is limited to case series on the role of
percutaneous intervention
(B) Embolic events involving the brain stem can be
life threatening
(C) Approximately 25% of patients with vertebrobasilar insufficiency have an associated significant carotid artery disease, the management
of which may relieve the symptoms
(D) The risk of recurrent stroke in the acute phase of
a vertebrobasilar TIA is low; however, the risk
is high for recurrent cerebrovascular diseases
(CVA) on longer term follow-up
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