Education Section: Associate Editors Florian Dick and Gert de Borst Eur J Vasc Endovasc Surg (2016) 51,

g (2016) 51, 460e462

CME MCQ Programme Sub-Editors: Séan Matheiken and Nikolaos Patelis

Multiple Choice Questions

1. Which ONE of the following was associated independently with an increased risk of a combined outcome of stroke,
myocardial infarction or death within 30 days of carotid stenting?

A. Male sex
B. Increased blood pressure
C. Age less than 70 years
D. Use of an open-cell stent
E. Use of combined antiplatelet therapy prior to stunting

2. Which ONE of the following is the most important potential advantage of a proximal scalloped stentgraft over a
branched stentgraft during thoracic endovascular aortic repair (TEVAR) in the aortic arch?

A. Better long term results

B. Increased sealing length along the outer curvature of the arch
C. Availability off the shelf
D. No need to catheterize the supra-aortic trunks
E. None of the above

3. Which ONE of the following statements is TRUE regarding internal iliac artery preservation in aorto-iliac aneurysm
cases involving one or both internal iliac artery ostia?

A. Iliac branched devices represent the only endovascular technique available

B. The risk of pelvic ischaemia increases with bilateral internal iliac artery occlusion
C. A randomised controlled trial has demonstrated that endovascular repair is the preferred treatment option to
preserve hypogastric artery perfusion as compared to open surgery
D. All sandwich graft techniques require a third endovascular access from the arm
E. There is level I evidence that iliac branched devices carry favorable patency rate when compared with sandwich-graft
techniques

4. Which ONE of the following arteries is most susceptible to occlusion (i.e. loss of patency) after multi-branched
endovascular aortic repair (EVAR)?

A. Celiac trunk
B. Superior mesenteric artery
C. Renal arteries
D. External iliac arteries
E. Internal iliac arteries

5. Which ONE of the following estimates is probably the BEST approximation of the true incidence of contrast-induced
nephropathy following coronary interventions?

A. 5-7%
B. 8-10%
C. 11-14%
D. 15-19%
E. >20

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6. Which ONE of the following is NOT an important advantage of endovascular simulation training?

A. It provides a risk-free environment for trainees to practice.

B. Difficult cases could be stored and later used for teaching as patient-specific procedural rehearsal
C. Time needed for patient-specific procedural rehearsal is short so it is cost-effective for training
D. Performance metrics such as procedure time and fluoroscopy time are useful as they could predict the overall
performance of trainees
E. Risk for trainer is reduced as attention is less diverged to trainees in the operating theatre

7. Which ONE of the following statements is most appropriate regarding Cone Beam Computed Tomography (CBCT)?

A. CBCT needs only a few images to work

B. CBCT is a rotational angiography that can be performed intraoperatively
C. CBCT needs a contrast medium to evaluate the stentgraft configuration accurately
D. CBCT can be performed in a manual way, without the need of a designed program
E. CBCT is a continuous fluoroscopy that limits the remodeling of the acquired image

8. Which ONE of the following should be the preferred method for surveillance of small popliteal artery aneurysms?

A. Physical examination
B. Angiography
C. Duplex ultrasound
D. CT Angiography
E. MRI

9. Which ONE of the following patient subgroups with acute lower extremity deep vein thrombosis (DVT) defined ac-
cording to duplex ultrasound findings represents ideal candidates for early clot removal?

A. Patients with iliofemoral DVT, without involvement of the popliteal vein and calf veins
B. Patients with femoropopliteal DVT, with or without calf vein DVT
C. Patients with DVT from the calf veins to the common femoral vein, with persisting inflow through the profunda
femoris vein
D. Patients with DVT in the femoral vein
E. Patients with ascending DVT from a superficial vein into a deep vein

10. According to a recent investigation, which ONE of the following is the MOST LIKELY effect of sclerotherapy of varicose
veins?

A. The sclerosant sodium tetradecyl sulphate (STS) completely destroys the endothelium, causing the formation of a
sclerothrombus and the eventual fibrosis of the vein
B. STS partially destroys the endothelium and activates apoptotic pathways in the media up to a depth of 400mm,
eventually resulting in fibrosis
C. STS completely penetrates the vein wall, destroying the endothelium, media and adventitia which causes the vein to
fibrous
D. STS partially destroys the endothelium and its effect penetrates into the media, activating apoptotic pathways and
resulting in the eventual fibrosis of the vein
E. STS completely penetrates the vein wall and activates cytochrome c and small mitochondria-derived activator of
caspases, causing mass apoptosis of all cells in the vein wall

11. Which ONE of the following statements is CORRECT?

A. Deep venous thrombosis requires compression therapy started as early as possible

B. Light calf compression stockings cannot prevent deep venous thrombosis during long haul flights
C. In patients with mixed venous and arterial leg ulcer compression therapy it not recommended
D. Donning devices (gliding socks and frames) are of no help. This is the reason why they are not more frequently used
E. Leg ulcer patients should always wear thigh compression stockings or tights to prevent extension of venous ulcers
to the thighs and groins
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12. The vacuum assisted laparotomy wound closure and mesh-mediated fascial traction method is composed by which
ONE of the following layer sequences, starting from the viscera?

A. Innermost plastic sheet, thick sponge, perforated polypropylene mesh

B. Perforated polypropylene mesh, plastic sheet, thick sponge
C. Innermost plastic sheet, perforated polypropylene mesh, thick sponge
D. Thick sponge, perforated polypropylene mesh, plastic sheet
E. Perforated polypropylene mesh, thick sponge, plastic sheet

13. Which ONE of the following definitions describes the concept of the minimally important difference (MID) BEST?

A. The MID represents the smallest detectable change on an outcome measure

B. The MID represents the smallest change on an outcome measure which clinicians value as important
C. The MID represents the smallest change on an outcome measure that proves statistically significant
D. The MID represents the smallest change on an outcome measure which patients value as important
E. The MID represents the smallest change on an outcome measure that indicates an improvement in quality of life

14. Which ONE of the following is the most often prescribed anti-platelet treatment in carotid artery stenting?

A. aspirin mono therapy

B. clopidogrel monotherapy
C. aspirin and clopidogrel dual anti platelet therapy
D. triple antiplatelet therapy
E. no anti platelet therapy

15. Which ONE of the following statements is TRUE regarding endovascular repair using an inner branched device?

A. It is solely proposed for patients deemed unfit for open surgery

B. It does not require experience in fenestrated and branched endografting
C. It is performed when the ascending aorta diameter is >40mm
D. It is performed to treat acute type A aortic dissections
E. It is contra-indicated if the patient has a mechanical aortic valve

16. Which ONE of these statements is correct regarding imaging studies used in the diagnosis of non-thrombotic iliac vein
lesions?

A. Plain venography is a more sensitive diagnostic modality than intravascular ultrasound

B. The use of intravascular ultrasound carries a moderate risk of provoking iliac vein thrombosis
C. The use of intravascular ultrasound is relatively free of complications
D. The large 8.5 Fr catheter needed for intravascular ultrasound produces access site complications
E. Intravascular ultrasound is highly sensitive for visualization of pathologic venous collaterals

Answers from previous issue (February 2016)

1A 2B 3A 4A 5B 6D 7B 8C 9A 10D 11B 12E 13B 14C