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ABR IR/DR practice questions

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Question 1Interventional Radiology

Which vessel is most commonly accessed for a percutaneous transhepatic cholangiography (PTC) when the right hepatic duct is the target?

  1. Left subcostal approach
  2. Transjugular approach
  3. Femoral artery approach
  4. Right mid-axillary intercostal approach Correct answer.

Explanation

A right-sided intercostal puncture through the mid-axillary line is the standard approach because the right hepatic duct system is large and peripherally accessible. A left approach is used when the right system is not accessible or is isolated.

Question 2Interventional Radiology

A patient develops hypotension, tachycardia, and flank pain immediately after renal biopsy. What is the most appropriate next step in management?

  1. Discharge with oral analgesics
  2. Obtain emergent CT and resuscitate with fluids and blood products Correct answer.
  3. Repeat the biopsy to confirm adequacy
  4. Schedule an outpatient ultrasound in one week

Explanation

The presentation is consistent with retroperitoneal hemorrhage, which requires immediate resuscitation and cross-sectional imaging to localize and quantify bleeding. Delay in recognition can be fatal.

Question 3Interventional Radiology

Which imaging modality is preferred for guiding percutaneous drainage of a deep pelvic abscess that is not accessible by ultrasound?

  1. Nuclear scintigraphy
  2. Fluoroscopy alone
  3. Plain radiography
  4. CT Correct answer.

Explanation

CT provides multiplanar anatomic detail and safe needle guidance for deep pelvic collections where ultrasound windows are limited by bowel and bone. Fluoroscopy alone lacks soft-tissue contrast, and radiography and scintigraphy cannot guide a needle.

Question 4Interventional Radiology

What is the primary purpose of placing a covered stent in a transjugular intrahepatic portosystemic shunt (TIPS)?

  1. To prevent hepatic encephalopathy
  2. To improve primary patency by preventing bile-related stenosis Correct answer.
  3. To eliminate the need for portal pressure measurement
  4. To reduce stent-graft cost

Explanation

Covered stent-grafts (e.g., PTFE) reduce bile leakage into the tract and tissue ingrowth, substantially improving primary patency compared with bare metal stents. They do not prevent encephalopathy, which is related to shunting physiology.

Question 5Interventional Radiology

Which of the following is the most common immediate complication of central venous catheter placement via the internal jugular vein?

  1. Pneumothorax
  2. Tracheal injury
  3. Carotid artery puncture Correct answer.
  4. Brachial plexus injury

Explanation

Inadvertent arterial puncture is the most frequent immediate complication of internal jugular access because the carotid artery lies adjacent to the vein. Pneumothorax is more associated with subclavian access.

Question 6Interventional Radiology

A patient with a coagulopathy requires an image-guided procedure. Which laboratory threshold is generally recommended before percutaneous needle procedures such as biopsy or drainage?

  1. INR less than 1.5 and platelets greater than 50,000/µL Correct answer.
  2. No laboratory thresholds are required for any percutaneous procedure
  3. INR less than 2.5 and platelets greater than 20,000/µL
  4. INR less than 3.0 and platelets greater than 10,000/µL

Explanation

Most society guidelines recommend correcting coagulopathy to an INR below approximately 1.5 and platelets above 50,000/µL before percutaneous needle procedures. Higher-risk procedures may require stricter thresholds.

Question 7Interventional Radiology

Which of the following is the preferred initial treatment for an acute iliofemoral deep vein thrombosis with limb-threatening phlegmasia cerulea dolens?

  1. Compression stockings
  2. Aspirin therapy
  3. Catheter-directed thrombolysis Correct answer.
  4. Systemic anticoagulation alone

Explanation

Phlegmasia cerulea dolens represents a limb-threatening emergency from massive venous occlusion, and catheter-directed thrombolysis (often with thrombectomy) is the preferred intervention to restore venous outflow. Anticoagulation alone is insufficient for limb salvage in this setting.

Question 8Interventional Radiology

What is the typical appearance of a properly positioned nasojejunal feeding tube on an abdominal radiograph?

  1. Tip in the left upper quadrant crossing the midline to the right Correct answer.
  2. Tip in the esophagus
  3. Tip in the gastric fundus
  4. Tip in the right lower quadrant

Explanation

A nasojejunal tube should pass through the stomach and duodenum with the tip located in the left upper quadrant projecting over the expected jejunum. Gastric placement indicates a nasogastric, not nasojejunal, position.

Question 9Interventional Radiology

A patient with a large hepatocellular carcinoma undergoes transarterial chemoembolization (TACE). Which vascular structure is most commonly identified as supplying the tumor?

  1. Hepatic vein branches
  2. Inferior phrenic artery
  3. Portal vein branches
  4. Hepatic artery branches Correct answer.

Explanation

Hepatocellular carcinoma is predominantly supplied by arterial branches, which is the basis for TACE; the portal vein supplies most normal hepatic parenchyma. This differential supply allows selective arterial therapy.

Question 10Interventional Radiology

During placement of a tunneled hemodialysis catheter, which of the following is the most reliable method to confirm adequate catheter tip position before securing the catheter?

  1. Measurement of the catheter length
  2. Fluoroscopic visualization of the tip at the cavoatrial junction Correct answer.
  3. Injection of saline through the distal lumen
  4. Auscultation of the catheter hub

Explanation

Fluoroscopy is the standard method to confirm the tip at the cavoatrial junction or right atrium, ensuring adequate flow and reducing complications. Clinical maneuvers and length measurements cannot reliably confirm position.

Question 11Interventional Radiology

Which of the following best describes the purpose of a retrievable inferior vena cava (IVC) filter?

  1. Temporary protection when anticoagulation is contraindicated, with later removal when safe Correct answer.
  2. Thrombectomy of the iliac veins
  3. Permanent protection against pulmonary embolism
  4. Treatment of chronic venous insufficiency

Explanation

Retrievable filters are placed for temporary protection in patients with contraindications to anticoagulation and are removed once anticoagulation can be safely resumed. They are not intended for chronic venous disease or thrombectomy.

Question 12Interventional Radiology

A patient undergoes radiofrequency ablation of a small renal cell carcinoma. Which of the following is the most important imaging finding to evaluate on immediate post-procedure imaging?

  1. Complete ablation with a low-attenuation zone and no enhancement
  2. Increase in tumor size
  3. Peripheral halo of enhancement
  4. Persistent nodular enhancement at the ablation margin Correct answer.

Explanation

Persistent nodular enhancement at the ablation margin suggests residual unablated tumor and requires additional treatment. A low-attenuation nonenhancing zone is expected and indicates successful ablation.

Question 13Interventional Radiology

Which of the following is the most appropriate initial management for a patient with an acute arterial hemorrhage from a pelvic fracture who is hemodynamically unstable?

  1. Emergent pelvic angiography with embolization Correct answer.
  2. Placement of a retrievable IVC filter
  3. Observation with serial hemoglobin checks
  4. Immediate surgical exploration of the pelvis

Explanation

Pelvic arterial hemorrhage is best managed with emergent angiography and embolization, which can control bleeding while avoiding the morbidity of pelvic surgery. IVC filters address venous thromboembolism, not arterial hemorrhage.

Question 14Interventional Radiology

What is the primary rationale for performing a transjugular liver biopsy rather than a percutaneous approach?

  1. It is faster than a percutaneous approach
  2. It provides larger tissue samples
  3. It avoids the need for any imaging guidance
  4. It allows measurement of hepatic venous pressure gradient and is safer in coagulopathic patients Correct answer.

Explanation

Transjugular liver biopsy allows simultaneous measurement of hepatic venous pressure gradient and is preferred in patients with coagulopathy or ascites because the transvenous route permits direct access to the hepatic vein. Percutaneous biopsy generally yields larger samples.

Question 15Interventional Radiology

Which of the following is the most likely cause of a high-pressure alarm during contrast injection through a central venous catheter?

  1. Low contrast viscosity
  2. Catheter kinking or fibrin sheath formation Correct answer.
  3. Large catheter diameter
  4. Catheter tip in the right atrium

Explanation

High-pressure alarms during injection usually reflect increased resistance from catheter kinking, fibrin sheath, or tip abutment against the vessel wall. Low viscosity and large diameter would reduce pressure.

Question 16Interventional Radiology

A patient develops signs of hepatic encephalopathy after TIPS creation. Which of the following is the most appropriate initial management?

  1. Initiation of anticoagulation
  2. Placement of a biliary drain
  3. Immediate TIPS reduction or occlusion
  4. Lactulose and dietary protein modification Correct answer.

Explanation

Mild to moderate post-TIPS encephalopathy is initially managed medically with lactulose and protein modification. Reduction or occlusion of the shunt is reserved for refractory cases.

Question 17Interventional Radiology

Which of the following best describes the purpose of a covered self-expanding metal stent in the palliation of malignant esophageal obstruction?

  1. To prevent gastroesophageal reflux
  2. To provide brachytherapy
  3. To cure the underlying malignancy
  4. To restore luminal patency and allow oral intake Correct answer.

Explanation

Esophageal stents are placed for palliation to restore luminal patency and permit oral intake in patients with malignant obstruction. They do not cure the malignancy or provide radiation therapy.

Question 18Interventional Radiology

A patient with a bleeding gastric varices is being considered for a balloon-occluded retrograde transvenous obliteration (BRTO). Which of the following is a prerequisite for the procedure?

  1. Normal hepatic function
  2. Presence of a TIPS
  3. Absence of portal hypertension
  4. A patent gastrorenal shunt Correct answer.

Explanation

BRTO requires a patent gastrorenal shunt to allow retrograde access to the varices. The procedure is often considered in patients with portal hypertension and gastric varices.

Question 19Interventional Radiology

Which of the following is the most appropriate treatment for a symptomatic simple hepatic cyst?

  1. Observation
  2. Percutaneous aspiration with sclerotherapy Correct answer.
  3. Percutaneous aspiration alone
  4. Surgical resection

Explanation

Symptomatic simple hepatic cysts are treated with aspiration followed by sclerotherapy (e.g., ethanol) to prevent recurrence. Aspiration alone has a high recurrence rate.

Question 20Interventional Radiology

A patient with a known bleeding disorder undergoes percutaneous nephrostomy placement. Which of the following is the most important factor in determining the access route?

  1. Using the largest possible needle
  2. Using a posterior approach only
  3. Avoiding the renal hilum and major vessels Correct answer.
  4. Avoiding the avascular plane of Brodel

Explanation

The access route should avoid the renal hilum and major vessels to reduce hemorrhagic complications, and the avascular plane of Brodel is the preferred target. Needle size does not determine the route.

Question 21Interventional Radiology

Which of the following is the most common cause of early failure of an arteriovenous fistula used for hemodialysis access?

  1. Aneurysm formation
  2. Venous stenosis Correct answer.
  3. Arterial stenosis
  4. Infection

Explanation

Venous stenosis, particularly at the juxta-anastomotic or outflow vein, is the most common cause of early fistula failure and is often treated with angioplasty. Arterial stenosis, infection, and aneurysm are less common causes of early failure.

Question 22Interventional Radiology

A patient with an acute ischemic stroke undergoes mechanical thrombectomy. Which of the following imaging findings is the most useful for selecting patients for thrombectomy beyond 6 hours from symptom onset?

  1. Presence of a microbleed on susceptibility-weighted imaging
  2. Large core infarct on noncontrast CT
  3. Small core and salvageable penumbra on perfusion imaging Correct answer.
  4. Elevated blood pressure

Explanation

Perfusion imaging identifying a small ischemic core with a large penumbra (mismatch) supports thrombectomy in extended time windows. A large core predicts poor outcome and increased hemorrhage risk.

Question 23Interventional Radiology

A patient with a large pulmonary arteriovenous malformation and a history of paradoxical embolic stroke is being evaluated for embolization. Which of the following is the most appropriate embolic agent and rationale?

  1. Balloon occlusion of the main pulmonary artery
  2. Coils or vascular plugs to occlude the feeding artery Correct answer.
  3. Ethanol to sclerose the draining vein
  4. Gelatin foam to temporarily occlude the nidus

Explanation

Pulmonary AVMs are typically treated by occluding the feeding artery with coils or vascular plugs, which prevents paradoxical emboli and reduces hemorrhage risk. Temporary agents and main pulmonary artery occlusion are inappropriate.

Question 24Interventional Radiology

A patient with a bleeding duodenal ulcer refractory to endoscopic therapy undergoes empiric embolization. Which of the following is the most important consideration to avoid ischemic complications?

  1. Embolize both gastroduodenal and superior mesenteric arteries
  2. Embolize as proximally as possible in the gastroduodenal artery
  3. Embolize distally and preserve collateral supply where possible Correct answer.
  4. Avoid embolization entirely and proceed to surgery

Explanation

Distal embolization near the bleeding site, with preservation of collateral supply, reduces the risk of duodenal or pancreatic ischemia. Proximal embolization may be less effective and can compromise collaterals.

Question 25Interventional Radiology

A patient with a suspected iatrogenic biliary leak after cholecystectomy undergoes a hepatobiliary scintigraphy and subsequent intervention. Which of the following is the most appropriate next step if a leak is confirmed at the cystic duct stump?

  1. Endoscopic retrograde cholangiopancreatography with sphincterotomy and stent placement Correct answer.
  2. Immediate hepatic resection
  3. Observation
  4. Percutaneous drainage alone

Explanation

A cystic duct stump leak is typically managed with ERCP, sphincterotomy, and stent placement to reduce the pressure gradient and allow healing. Percutaneous drainage may be adjunctive for collections but does not address the leak directly.

Question 26Interventional Radiology

Which access route is most commonly used for percutaneous transhepatic cholangiography when the intrahepatic bile ducts are dilated?

  1. Right paramedian approach
  2. Midline epigastric approach
  3. Right midaxillary intercostal approach Correct answer.
  4. Left subcostal approach

Explanation

A right lateral intercostal puncture through the midaxillary line enters the peripheral right hepatic duct, which is preferred because it is distant from major central vessels and hilar structures. This route minimizes bleeding and bile leak risk when ducts are dilated.

Question 27Interventional Radiology

A patient develops sudden hypotension, tachycardia, and a rapidly enlarging groin hematoma shortly after common femoral artery puncture. What is the most appropriate next step?

  1. Elective surgical exploration in 24 hours
  2. Manual compression of the puncture site and volume resuscitation Correct answer.
  3. Immediate discharge with outpatient follow-up
  4. Oral anticoagulation and observation

Explanation

This presentation is consistent with active bleeding or a retroperitoneal/groin hematoma after femoral access. First-line management is direct manual compression with hemodynamic resuscitation and monitoring.

Question 28Interventional Radiology

Which imaging modality is most commonly used to guide percutaneous drainage of an abdominal abscess?

  1. PET-CT
  2. Ultrasound or CT Correct answer.
  3. Plain radiography
  4. Fluoroscopy alone

Explanation

Cross-sectional imaging with ultrasound or CT provides real-time or near-real-time visualization of the collection and adjacent structures for safe catheter placement. Fluoroscopy alone cannot reliably depict soft-tissue collections.

Question 29Interventional Radiology

Which of the following best describes the primary function of an angioplasty balloon catheter in the treatment of a hemodialysis access stenosis?

  1. To aspirate thrombus
  2. To deliver embolic coils
  3. To radially dilate the stenotic segment Correct answer.
  4. To occlude flow during embolization

Explanation

A balloon catheter is inflated across a stenosis to radially stretch and disrupt the narrowing. This restores luminal diameter and improves access flow.

Question 30Interventional Radiology

A patient is scheduled for percutaneous biopsy of a lung nodule. Which factor most increases the risk of pneumothorax after the procedure?

  1. Supine patient positioning
  2. Small lesion size and increased needle passes Correct answer.
  3. Use of local anesthesia
  4. Use of a coaxial technique

Explanation

Small and deep lesions require more needle passes and more angulation, increasing the chance of traversing pleura repeatedly and causing pneumothorax.

Question 31Interventional Radiology

Which of the following is the recommended first step when a patient with a known iodinated contrast allergy requires an urgent contrast-enhanced procedure?

  1. Proceed without any precautions
  2. Use a higher contrast dose
  3. Premedicate with corticosteroids and antihistamines Correct answer.
  4. Cancel the procedure

Explanation

For patients with prior contrast reactions who require contrast, premedication with corticosteroids and antihistamines reduces the risk of a recurrent reaction. The urgency and benefit must be weighed against the delay.

Question 32Interventional Radiology

What is the typical sonographic appearance of a successfully thrombosed pseudoaneurysm after ultrasound-guided compression or thrombin injection?

  1. A patent neck with arterial flow
  2. High-velocity arterial jet in the sac
  3. Absence of flow within the sac Correct answer.
  4. Increased sac size with bruit

Explanation

Successful thrombosis is confirmed by absence of color and spectral flow within the pseudoaneurysm sac. A residual patent neck or intralesional flow indicates failure.

Question 33Interventional Radiology

Which of the following patients is the most appropriate candidate for uterine artery embolization for symptomatic fibroids?

  1. A woman with symptomatic leiomyomas who desires uterine preservation Correct answer.
  2. A woman with active pelvic infection
  3. A woman with suspected pregnancy
  4. A woman with a coagulopathy that cannot be corrected

Explanation

Uterine artery embolization is indicated for symptomatic fibroids in patients who wish to preserve the uterus. Active infection, pregnancy, and uncorrectable coagulopathy are contraindications.

Question 34Interventional Radiology

During percutaneous vertebroplasty, which of the following is the most important technical goal when injecting bone cement?

  1. Inject cement under high pressure to fill all trabeculae
  2. Maximize injection volume regardless of spread
  3. Confine cement to the vertebral body and avoid venous or epidural leakage Correct answer.
  4. Position the needle tip within the spinal canal

Explanation

The key technical objective is to fill the fractured vertebral body while avoiding leakage into veins, the epidural space, or the spinal canal, which can cause serious complications. Injection is stopped if leakage is seen.

Question 35Interventional Radiology

Which of the following best explains why carbon dioxide is used as a contrast agent for venography in patients with renal insufficiency?

  1. It provides better opacification than iodinated contrast
  2. It remains in the body for weeks
  3. It is nephrotoxic but inexpensive
  4. It is non-nephrotoxic and rapidly cleared by the lungs Correct answer.

Explanation

Carbon dioxide is not nephrotoxic and is highly soluble, being eliminated by the lungs within minutes. This makes it attractive for venous imaging in patients at risk for contrast-induced nephropathy.

Question 36Interventional Radiology

A patient undergoes percutaneous transhepatic biliary drainage. Several days later the catheter is accidentally dislodged. What is the most appropriate management?

  1. Leave the tract alone and observe
  2. Perform an immediate biliary-enteric anastomosis
  3. Remove any remaining external tubing and discharge
  4. Reinsert or place a new drainage catheter promptly to maintain tract access Correct answer.

Explanation

Early dislodgement risks bile leak, peritonitis, and loss of the established tract. Prompt reinsertion or replacement over a wire preserves access and drainage.

Question 37Interventional Radiology

Which of the following is the most common site for placing a tunneled central venous catheter for long-term hemodialysis access when the right internal jugular vein is unavailable?

  1. Left internal jugular vein Correct answer.
  2. Femoral vein
  3. Subclavian vein on the side of a planned fistula
  4. Right external jugular vein

Explanation

The left internal jugular vein is the preferred alternative when the right internal jugular vein cannot be used. Subclavian access is avoided because it can cause venous stenosis that compromises future ipsilateral access.

Question 38Interventional Radiology

A patient with a large, symptomatic simple renal cyst undergoes percutaneous sclerotherapy. Which agent is commonly instilled after aspiration?

  1. Absolute ethanol Correct answer.
  2. Normal saline
  3. Iodinated contrast
  4. Hypertonic saline

Explanation

Absolute ethanol is a commonly used sclerosant that destroys the cyst-lining epithelium after complete aspiration. The volume instilled is limited to a fraction of the aspirated volume to reduce systemic absorption.

Question 39Interventional Radiology

Which of the following best describes the purpose of embolization in the management of a bleeding pseudoaneurysm of the gastroduodenal artery?

  1. To deliver chemotherapy
  2. To occlude the feeding vessel and arrest hemorrhage Correct answer.
  3. To dilate the vessel and improve perfusion
  4. To increase arterial flow to the duodenum

Explanation

Embolization occludes the arterial supply to the pseudoaneurysm, arresting hemorrhage while collateral flow preserves organ perfusion. Coils or liquid embolic agents are typically used.

Question 40Interventional Radiology

A patient with a malfunctioning tunneled dialysis catheter is found to have a fibrin sheath. Which of the following is the most appropriate initial management?

  1. Systemic anticoagulation for six months
  2. Catheter-directed thrombolysis or fibrin sheath disruption Correct answer.
  3. Balloon angioplasty of the ipsilateral subclavian vein
  4. Immediate catheter removal and placement of a new catheter on the opposite side

Explanation

A fibrin sheath causing catheter malfunction can often be treated with intraluminal thrombolysis or mechanical disruption, preserving the existing access. Replacement is reserved for failure of these measures.

Question 41Interventional Radiology

Which of the following is the most appropriate imaging guidance for percutaneous radiofrequency ablation of a small hepatic metastasis located near the diaphragm?

  1. Fluoroscopy without contrast
  2. Plain radiography
  3. CT with multiplanar reconstruction Correct answer.
  4. Ultrasound only

Explanation

CT with multiplanar reconstruction allows accurate probe placement and monitoring of the ablation zone, especially for lesions near the diaphragm that may be obscured on ultrasound.

Question 42Interventional Radiology

A patient develops contrast-induced nephropathy after an arteriogram. Which of the following best describes the typical clinical course?

  1. Creatinine falls below baseline within 12 hours
  2. Serum creatinine rises immediately and peaks within 1 hour
  3. Serum creatinine rises within 24 to 72 hours and usually peaks by 3 to 5 days Correct answer.
  4. Creatinine remains unchanged but oliguria persists for weeks

Explanation

Contrast-induced nephropathy typically manifests as a creatinine rise within 24 to 72 hours after contrast administration, peaking around 3 to 5 days and generally resolving.

Question 43Interventional Radiology

During transjugular intrahepatic portosystemic shunt creation, which of the following measurements is most important for confirming an adequate shunt?

  1. Portosystemic pressure gradient after shunt creation Correct answer.
  2. Right atrial pressure before puncture
  3. Portal vein diameter before puncture
  4. Hepatic artery flow velocity

Explanation

The portosystemic pressure gradient after stent deployment is the key physiologic measure of shunt function, with a target generally below 12 mm Hg. An inadequate gradient prompts further dilation or revision.

Question 44Interventional Radiology

A patient with a bleeding arteriovenous malformation in the colon is being considered for embolization. Which of the following is the most important consideration to avoid ischemic complications?

  1. Embolizing both the superior and inferior mesenteric arteries
  2. Using the largest possible embolic particles
  3. Preserving collateral flow and avoiding extensive distal embolization Correct answer.
  4. Using only mechanical coils distally

Explanation

Colonic embolization must preserve collateral perfusion to avoid bowel ischemia. Superselective catheterization and careful choice of embolic agent reduce the risk of infarction.

Question 45Interventional Radiology

A patient with a large, symptomatic arteriovenous fistula in the pelvis is treated with embolization. Which of the following best explains why a detachable balloon or Amplatzer device may be preferred over coils?

  1. They increase flow through the fistula
  2. They are radiolucent
  3. They provide a more controlled occlusion and reduce migration risk in high-flow lesions Correct answer.
  4. They dissolve over time

Explanation

In high-flow shunts, detachable balloons or vascular plugs provide controlled deployment and a lower risk of migration compared with coils. This improves precise occlusion of the fistula.

Question 46Interventional Radiology

A patient with a retained biliary stent and recurrent cholangitis is referred for percutaneous management. Which of the following is the most appropriate initial step?

  1. Immediate stent removal without imaging
  2. Percutaneous transhepatic cholangiography with drainage of the infected biliary system Correct answer.
  3. Elective surgical revision
  4. Oral antibiotics alone without drainage

Explanation

In cholangitis with obstruction, source control through biliary drainage is essential in addition to antibiotics. Percutaneous transhepatic cholangiography allows diagnosis and decompression.

Question 47Interventional Radiology

A patient with a bleeding gastric varix undergoes balloon-occluded retrograde transvenous obliteration. Which of the following best describes the mechanism of action?

  1. Direct embolization of the portal vein
  2. Occlusion of the gastrorenal shunt with a balloon followed by injection of sclerosant into the varices Correct answer.
  3. Balloon dilation of the splenic vein
  4. Placement of a covered stent across the varix

Explanation

BRTO uses a balloon to occlude the gastrorenal shunt, then injects sclerosant into the varices to obliterate them. This reduces variceal bleeding while preserving portal flow.

Question 48Interventional Radiology

A patient with a large pulmonary arteriovenous malformation and a history of paradoxical stroke is being evaluated for embolization. Which of the following best explains the rationale for treatment?

  1. To reduce the risk of paradoxical embolic stroke and hypoxemia Correct answer.
  2. To improve systemic oxygenation by increasing shunt flow
  3. To prevent pulmonary embolism
  4. To increase pulmonary arterial pressure

Explanation

Pulmonary AVMs create a right-to-left shunt that allows paradoxical emboli to reach the systemic circulation. Embolization reduces shunt flow, lowering stroke risk and improving oxygenation.

Question 49Interventional Radiology

Which of the following best explains why superselective catheterization is preferred during embolization of a bleeding duodenal ulcer?

  1. It avoids the need for anticoagulation
  2. It allows occlusion of the bleeding vessel while preserving collateral supply to the bowel Correct answer.
  3. It reduces the total procedure time
  4. It eliminates the need for fluoroscopy

Explanation

Superselective catheterization targets the bleeding vessel while preserving collateral perfusion to the duodenum and surrounding structures, reducing ischemic complications.

Question 50Interventional Radiology

Which vessel is most commonly punctured for a standard transfemoral arterial access in adults?

  1. Common femoral artery Correct answer.
  2. External iliac artery
  3. Superficial femoral artery
  4. Profunda femoris artery

Explanation

Femoral access is obtained at the common femoral artery, ideally near the femoral head, because it is a large, compressible vessel that can be safely hemostased after sheath removal. Punctures above or below this level raise the risk of uncontrolled bleeding or pseudoaneurysm.