Patient population includes coronary artery disease, STEMI, cardiogenic shock, complex total occlusions, valvular disease, renal disease, carotid stenosis, limb salvage, peripheral stenosis, thrombosis disease, Impella and LVAD insertions. Experience with vasoactive and sedation drug administration, sterile technique, air management, laser and lithotripsy atherectomy, and cardiac cath lab and peripheral IV skills required.