Periprocedural Myocardial Infarction and Emboli Protection

Periprocedural Myocardial Infarction and Emboli Protection
Periprocedural Myocardial Infarction and Emboli Protection
Which of the following is the most common cause of
periprocedural myocardial infarction (MI)?
(A) Side branch closure
(B) Occlusive dissection
(C) Microvascular obstruction due to embolization
(D) Epicardial obstruction due to thrombus formation
2 In which of the following percutaneous coronary
interventions (PCIs) is there no risk of embolization?
(A) Rotational atherectomy
(B) Directional coronary atherectomy (DCA)
(C) Balloon angioplasty
(D) Extraction atherectomy
(E) Angioplasty with stent deployment
(F) None of the above
3 Which of the following is not associated with an increased degree of embolization during percutaneous
intervention?
(A) Large plaque burden
(B) Use of DCA
(C) Use of glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitors
(D) Saphenous vein grafts (SVG) interventions
(E) Diffuse atherosclerosis
4 In the Enhanced Myocardial Efficacy and Recovery
by Aspiration of Liberated Debris (EMERALD)
trial, the use of a balloon occlusion and aspiration
distal microcirculatory system during PCI for acute
ST-segment elevation myocardial infarction was
shown to improve, which of the following?
(A) Microvascular flow
(B) Success of reperfusion
(C) Infarct size
(D) ST-segment resolution
(E) None of the above
5 Which of the following treatments has been shown,
in a reasonably powered randomized trial, to
significantly reduce the risk of periprocedural MI?
(A) Pretreatment with atorvastatin before elective
coronary intervention
(B) Pretreatment with intragraft verapamil before
SVG intervention
(C) Thrombectomy before stent implantation in
SVG intervention
(D) Rotational atherectomy
(E) Intracoronary urokinase
6 In which of the following interventions has the
use of abciximab been shown to reduce the rate
of periprocedural MI?
(A) Percutaneous transluminal angioplasty
(B) DCA
(C) Elective stenting
(D) Bailout stenting
(E) All of the above
(F) None of the above
7 Which of the following has been shown to decrease
distal embolization during percutaneous intervention of SVGs?
(A) Aspiration thrombectomy with a transluminal
extraction catheter
97
98 900 Questions: An Interventional Cardiology Board Review
(B) Use of polytetrafluoroethylene (PTFE)-covered
stent
(C) DCA
(D) Use of distal balloon occlusion and aspiration
system
(E) None of the above
8 Which of the following is an advantage of a filter
device as compared with a balloon occlusion device
for embolic protection?
(A) Increased impedance of distal flow of cytokines
and other vasoactive substances
(B) Better retrieval profile
(C) Better embolic protection
(D) Better visualization of vessel
(E) Better crossing profile
9 In the SVG Angioplasty Free of Emboli Randomized (SAFER) trial, the use of a balloon occlusion/aspiration system (PercuSurge GuardWire) was
associated with which of the following outcomes?
(A) Statistically significant reduction in mortality
(B) Statistically significant increase in incidence of
complications including distal dissection and
perforation
(C) Statistically significant reduction in MI and ‘‘no
reflow’’ phenomenon
(D) A and B
(E) A, B and C
10 What is the average rate of major adverse cardiovascular events (MACEs) at 30 days with the use
of the currently approved emboli protection devices
(EPDs) during PCI of SVGs?
(A) 0% to 15%
(B) 16% to 30%
(C) 31% to 45%
(D) 46% to 60%
(E) >60%
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