Cath Conference

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# Cath Conference
## JBVA Cardiac Catheterization Lab
### Anish Sanjay Shah, MD<br><span style="font-size: 70%;">Cardiology Fellow<br>University of Illinois at Chicago</span>
### October 05, 2021

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# Case 1

69M h/o PAD, ESRD s/p LUE-AVF, MM, DM  
p/w left foot gangrene (recent amputation)  
c/s pre-op LHC for BKA  
DSE = severe apical hypokinesis  
PCI = DK crush

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## Diagnostic Component

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## Interventional Component

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### Access
Left Femoral, 7F 
XB 3.5 guide  
BMW x2 to wire LAD and LCX

### Interventions
IVUS of LAD and LCX to evaluate lesions  
Shockwave (4x12) for both lesions  
PCI of mLAD with 3x15  
DK crush of LM lesion with 4x15 in LCX and 4x18 mm to LAD  
Perclose and manual pressure for hemostasis  
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### Outcomes
- LM bifurcation disease, Medina 1,1,1
- 270 degrees of calcium in oLAD and oLCX  
- Utility in Shockwave to decrease wire crossing for DK crush approach  
- Successful LM kissing stents with mLAD stent  
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# Case 2

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### Access
Right Radial, 5F  
Terumo Tiger, 5F

### Interventions
10 mg verapamil IA   
Nitroglycerin 600 mcg IA  
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### Outcomes
- Nonobstructive CAD  
- High right radial  
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# Case 3

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### Access
Left Radial, 6F  
XB-4 guide for LCA  
JR-4 guide for RCA

### Interventions
IVUS of mLAD (360 degrees calcium in mLAD)  
Guideliner for support  
Orbital atherectomy (CSI)  
Stent placed with post IVUS imaging  
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### Outcomes
- 3.5x38 to mLAD
- 4.5x12 to pLAD  
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