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You answered correctly!
The correct answer is (e) all the above. The other factors (a-d) have all been identified as factors potentially increasing the risk of vascular access and closure.
You answered incorrectly.
The correct answer is (a) early recognition of failed hemostasis. The closure angiogram specifically identifies local, arterial site bleeding. Other options (b) arterial narrowing at the access site is an uncommon finding and unlikely to be clinically relevant, while (c) is not an indication for an angiogram in the absence of symptoms of peripheral ischemia. Thus (e) is not a possible option.
The correct answer is (d) all the above. Suture based closure devices are most likely to fail in smaller vessels (a), when the puncture site is in a calcified segment (b) or if the subcutaneous tract was incompletely prepped and/or enlarged (c).
The correct answer is (c) use of a long sheath if tissue depth is greater than 5 cm. This is to avoid sheath not being securely in the artery. Incorrect options include (a) use of a large bore needle for access. Current optimal practice emphasized micro puncture to minimize arterial damage. In addition, (b) hand holding is more difficult in obese patients and thus closure devices are encouraged as compression is more difficult with added subcutaneous thickness over the artery limiting the ability to localize the arteriotomy access site for local compression. Lastly. With divergent answers, all the above (d) is not a correct answer.