class: center, middle, inverse, title-slide # Cath Conference ## UIC Cardiac Catheterization Lab ### Anish Sanjay Shah, MD<br><span style="font-size: 70%;">Cardiology Fellow<br>University of Illinois at Chicago</span> ### November 16, 2021 --- class: center, middle, inverse # Case 1 51M h/o ESRD, HTN, DMT2 p/w renal pre-transplant evaluation --- background-image: url("3262-1086-1503-0113_series_11.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_12.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_14.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_16.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_17.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_22.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_26.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_28.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_29.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_3.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_31.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_33.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_34.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_36.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_37.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_4.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_47.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_48.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_5.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_50.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_7.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_8.gif") background-size: contain --- background-image: url("3262-1086-1503-0113_series_9.gif") background-size: contain --- .pull-left[ ### Access Right radial artery, 6F sheath 5F JR-4 and JL-3.5 diagnostic RCA guide with 6F AL-0.75 LCA guide with 6F EBU-3.5 ### Interventions RCA wired with Sion Blue Predilation and IVUS of RCA DES to RCA LM wired with Sion Blue Re-dilation and IVUS of LAD DES to mLAD and pLAD Post-IVUS run ] .pull-right[ ### Outcomes - 3.0 x 38 mm DES to pRCA - 3.5 x 38 mm DES to mLAD - 3.0 x 12 mm DES to mLAD (overlap) - Successful TIMI 3 flow in RCA/LCA ] --- class: center, middle, inverse # Case 2 59F h/o CAD, HTN, HLD, DM p/w typical chest pain x 8 hours overnight ECG = STEMI, Wellen's type A ECG pattern --- background-image: url("4262-1086-3713-0170_series_1.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_10.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_13.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_19.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_2.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_20001_5.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_23.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_27.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_28.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_3.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_33.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_4.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_5.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_6.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_7.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_8.gif") background-size: contain --- background-image: url("4262-1086-3713-0170_series_9.gif") background-size: contain --- .pull-left[ ### Access Left radial 6F sheath (right too small caliber) 5F JR-4 and JL-3.5 diagnostic LCA with XB-3.5 guide ### Interventions BMW into diagonal Pilot 50 into dLAD IVUS of lesion with 360˚ calcium IVL DES to pLAD ] .pull-right[ ### Outcomes - Successful TIMI-3 flow - Shockwave 4.0 x 12 mm x 5 cycles - 4.0 x 18 mm DES to pLAD ] --- class: center, middle, inverse # Case 3 51M h/o HTN, cocaine abuse p/w OSH transfer for SAH/AMS Troponin = 31 ECG = inferior STEMI POCUS = inferior wall hypokinesis --- background-image: url("3362-1086-1083-0172_series_1.gif") background-size: contain --- background-image: url("3362-1086-1083-0172_series_2.gif") background-size: contain --- background-image: url("3362-1086-1083-0172_series_3.gif") background-size: contain --- background-image: url("3362-1086-1083-0172_series_4.gif") background-size: contain --- background-image: url("3362-1086-1083-0172_series_5.gif") background-size: contain --- background-image: url("3362-1086-1083-0172_series_6.gif") background-size: contain --- background-image: url("3362-1086-1083-0172_series_7.gif") background-size: contain --- background-image: url("3362-1086-1083-0172_series_8.gif") background-size: contain --- .pull-left[ ### Access Right radial artery, 6F sheath 5F Tiger for RCA/LCA ### Interventions None ] .pull-right[ ### Outcomes - Nonobstructive CAD - Significant tortuosity - Large caliber vessels - Suspected severe cocaine vasospasm ]