VASCULAR ARDMS (ACTUAL 2025/2026) QUESTIONS AND
VERIFIED ANSWERS
what will doppler demonstrate with hep v obstruction - --
Answers----a lack of flow in the hepatic veins at the site of the
occlusion and collateral pathways that don't follow the usual
vsculature course. A bicolor flow in the hepatic veins (one
branch blue and the other red) is a good indication of proximal
vein occlusion and distal patency, caudate veins enlarge greater
than 3mm (specific to budd chiari in the absence of CHF)
what is a method of treating portal HTN - --Answers----TIPS-
transjugular intrahepatic portosystemic shunts
what are the normal findings associated with a TIPS - --
Answers----flight protrusion of ends of shunt into portal and
hepatic veins, fully filled stent, monophasic slightly pulsatile
flow, moderate spectral broadening, PSV from at least 50-60
cm/sec to 90-120 cm/ sec, similar velocities at both ends,
hepatopedal flow in portal, increase in portal flow comared to
pre shunt status, portal velocity of at least 30 cm/sec with
normal range of 37-47 cm/sec
what is a TIPS - --Answers----this is a channel created between
the high pressure portal system and the low pressure hepatic
veins and installed via the jugular vein
,what are the features of a TIPS stent - --Answers----metallic
device used to create shunt or channel and easily visualized
what should a pre-op sonogram of a TIPS include - --Answers--
--should include documentation of flow and patency in the PV,
SV, and SMV. Evaluate the liver as well. Location of hepatomas
may change the plan for a shunt depending on the tumor's
location
what should a post-op sonogram of a TIPS include - --Answers-
---approximately within the first 24 hours of TIPS placement,
document the patency of the TIPS and establish baseline
velocities
what is the most common site of a stent stenosis - --Answers--
--at the hepatic end of the shunt
how is the stenosis visualized within a TIPS - --Answers----a
high velocity flow less than 50-60 cm/s is a clue the shunt is
malfunctioning, flow increasing to more than 100 cm/s is
indicative of stenosis
what are the positive aspects of a shunt - --Answers----
reduces ascites, prevents collateral hemorrhage, and increased
quality of life
, what is the highest risk of stenosis and occlusion in a shunt
within the first few weeks - --Answers----thrombus
what is the highest risk of stenosis and occlusion in a shunt later
on - --Answers----neointimal hyperplasia
what do the splanching arteries supply - --Answers----the
blood to the bowel
what vessels are splanching or mesenteric arteries - --
Answers----celiac, sma, ima
what is the purpose of evaluating the mesenteric arteries - --
Answers----to look for songraphic signs of mesenteric ischemia
(Often prevented due to collateralization)
what are the normal velocities of the celiac arteries - --
Answers----PSV 50-160 cm/s and EDV of less than 50 cm/s
what are the normal velocities of the sma preprandial - --
Answers----110-180 cm/s
what are the normal velocities of the sma postprandial - --
Answers----broad PSV ranges
VERIFIED ANSWERS
what will doppler demonstrate with hep v obstruction - --
Answers----a lack of flow in the hepatic veins at the site of the
occlusion and collateral pathways that don't follow the usual
vsculature course. A bicolor flow in the hepatic veins (one
branch blue and the other red) is a good indication of proximal
vein occlusion and distal patency, caudate veins enlarge greater
than 3mm (specific to budd chiari in the absence of CHF)
what is a method of treating portal HTN - --Answers----TIPS-
transjugular intrahepatic portosystemic shunts
what are the normal findings associated with a TIPS - --
Answers----flight protrusion of ends of shunt into portal and
hepatic veins, fully filled stent, monophasic slightly pulsatile
flow, moderate spectral broadening, PSV from at least 50-60
cm/sec to 90-120 cm/ sec, similar velocities at both ends,
hepatopedal flow in portal, increase in portal flow comared to
pre shunt status, portal velocity of at least 30 cm/sec with
normal range of 37-47 cm/sec
what is a TIPS - --Answers----this is a channel created between
the high pressure portal system and the low pressure hepatic
veins and installed via the jugular vein
,what are the features of a TIPS stent - --Answers----metallic
device used to create shunt or channel and easily visualized
what should a pre-op sonogram of a TIPS include - --Answers--
--should include documentation of flow and patency in the PV,
SV, and SMV. Evaluate the liver as well. Location of hepatomas
may change the plan for a shunt depending on the tumor's
location
what should a post-op sonogram of a TIPS include - --Answers-
---approximately within the first 24 hours of TIPS placement,
document the patency of the TIPS and establish baseline
velocities
what is the most common site of a stent stenosis - --Answers--
--at the hepatic end of the shunt
how is the stenosis visualized within a TIPS - --Answers----a
high velocity flow less than 50-60 cm/s is a clue the shunt is
malfunctioning, flow increasing to more than 100 cm/s is
indicative of stenosis
what are the positive aspects of a shunt - --Answers----
reduces ascites, prevents collateral hemorrhage, and increased
quality of life
, what is the highest risk of stenosis and occlusion in a shunt
within the first few weeks - --Answers----thrombus
what is the highest risk of stenosis and occlusion in a shunt later
on - --Answers----neointimal hyperplasia
what do the splanching arteries supply - --Answers----the
blood to the bowel
what vessels are splanching or mesenteric arteries - --
Answers----celiac, sma, ima
what is the purpose of evaluating the mesenteric arteries - --
Answers----to look for songraphic signs of mesenteric ischemia
(Often prevented due to collateralization)
what are the normal velocities of the celiac arteries - --
Answers----PSV 50-160 cm/s and EDV of less than 50 cm/s
what are the normal velocities of the sma preprandial - --
Answers----110-180 cm/s
what are the normal velocities of the sma postprandial - --
Answers----broad PSV ranges
