INTERN YEAR - ROTATION 5
(VASCULAR) EXAM WITH 100%
CORRECT ANSWERS 2026
absolute contraindications to thrombolysis answer active
bleeding diathesis
gastrointestinal bleed within the past 10 days
cerebrovascular accident in the past 2 months
intracranial/spinal surgery or intracranial trauma in the past 3
months
Relative contraindications to thrombolysis answer major surgery
or trauma in the past 10 days, uncontrolled hypertension,
intracranial tumor, or recent eye surgery
Minor contraindications to thrombolysis answer hepatic failure,
bacterial endocarditis, pregnancy, and diabetic hemorrhagic
retinopathy.
what do you use if pt has HIT (heparin allergy)? answer
argatroban or bivalirudin
TCAR answer Transcarotid Artery Revascularization
TCAR is a minimally invasive procedure that can clear blockages
and open a narrowed carotid artery. The surgeon makes an
,incision over the common carotid artery to perform the repair.
During the TCAR procedure, the surgical team reverses blood flow
in the area of the blockage.
endoleak answer describes the presence of persistent flow of
blood into the aneurysm sac after device placement
type 1a endoleak answer persistent blood flow into the
aneurysmal sac from proximally. Incomplete proximal sealing
results in type Ia endoleak in about 4% of all patients treated with
EVAR
type 1b endoleak answer type IB endoleaks occur at one of the
distal iliac artery attachment sites; treated by secondary TEVAR
and distal stent-graft extension
type II endoleak answer retrograde flow in branch vessel
(lumbar, inferior mesenteric, accessory renal, and internal iliac
arteries)
treatment for type II endoleak without sac growth answer serial
exams
treatment for type II endoleak with sac growth answer In
general, type II IMA endoleaks are treated by selecting the middle
colic artery through the superior mesenteric artery and
retrograde access to the IMA through the marginal artery.
type III endoleak answer Device failure causing leakage through
the graft fabric or segments of the modular graft; a graft defect
, type IV endoleak answer Diagnosis of exclusion- Porous graft-
Transient and seen intra-procedurally. Usually resolves within one
month after stopping anticoagulation. Rarely seen with modern
grafts.
type V endoleak answer Endotension
Continued expansion of aneurysm sac without demonstrable leak
on imaging
endoleak types answer 1: leak at the top (A) or bottom (B) of
the graft
-Typically high pressure and require intervention.
2: Most common. Filling of sac via a feeder artery, usually IMA or
lumbar artery. Most resolve, but should be followed to ensure
stability.
3: Defect/fracture in the graft, usually from pieces that don't fully
overlap.
4: Porosity of the graft (4 is from the pore). Doesn't happen with
modern grafts.
5: Endotension. Not a true leak, and may be due to pulsation of
the graft wall.
(VASCULAR) EXAM WITH 100%
CORRECT ANSWERS 2026
absolute contraindications to thrombolysis answer active
bleeding diathesis
gastrointestinal bleed within the past 10 days
cerebrovascular accident in the past 2 months
intracranial/spinal surgery or intracranial trauma in the past 3
months
Relative contraindications to thrombolysis answer major surgery
or trauma in the past 10 days, uncontrolled hypertension,
intracranial tumor, or recent eye surgery
Minor contraindications to thrombolysis answer hepatic failure,
bacterial endocarditis, pregnancy, and diabetic hemorrhagic
retinopathy.
what do you use if pt has HIT (heparin allergy)? answer
argatroban or bivalirudin
TCAR answer Transcarotid Artery Revascularization
TCAR is a minimally invasive procedure that can clear blockages
and open a narrowed carotid artery. The surgeon makes an
,incision over the common carotid artery to perform the repair.
During the TCAR procedure, the surgical team reverses blood flow
in the area of the blockage.
endoleak answer describes the presence of persistent flow of
blood into the aneurysm sac after device placement
type 1a endoleak answer persistent blood flow into the
aneurysmal sac from proximally. Incomplete proximal sealing
results in type Ia endoleak in about 4% of all patients treated with
EVAR
type 1b endoleak answer type IB endoleaks occur at one of the
distal iliac artery attachment sites; treated by secondary TEVAR
and distal stent-graft extension
type II endoleak answer retrograde flow in branch vessel
(lumbar, inferior mesenteric, accessory renal, and internal iliac
arteries)
treatment for type II endoleak without sac growth answer serial
exams
treatment for type II endoleak with sac growth answer In
general, type II IMA endoleaks are treated by selecting the middle
colic artery through the superior mesenteric artery and
retrograde access to the IMA through the marginal artery.
type III endoleak answer Device failure causing leakage through
the graft fabric or segments of the modular graft; a graft defect
, type IV endoleak answer Diagnosis of exclusion- Porous graft-
Transient and seen intra-procedurally. Usually resolves within one
month after stopping anticoagulation. Rarely seen with modern
grafts.
type V endoleak answer Endotension
Continued expansion of aneurysm sac without demonstrable leak
on imaging
endoleak types answer 1: leak at the top (A) or bottom (B) of
the graft
-Typically high pressure and require intervention.
2: Most common. Filling of sac via a feeder artery, usually IMA or
lumbar artery. Most resolve, but should be followed to ensure
stability.
3: Defect/fracture in the graft, usually from pieces that don't fully
overlap.
4: Porosity of the graft (4 is from the pore). Doesn't happen with
modern grafts.
5: Endotension. Not a true leak, and may be due to pulsation of
the graft wall.
