PMC10205987_01
Kidney-ureter-bladder X-ray and fluoroscopy localization before shockwave lithotripsy: right renal stone with a size of 10 x 6 mm.
fmed-10-1147725-g0001.jpg
PMC10205987_01_fmed-10-1147725-g0001.jpg
F1
The stone size was approximately 10 x 6 mm on kidney-ureter-bladder X-ray and fluoroscopy scan (Figure 1) at treatment initiation.
A 12-lead electrocardiogram. Significant ST-segment elevation over V1-V4, hyperacute T over V2-V3, and reciprocal change over leads III and aVF. The patient's troponin level was elevated to 0.239 ng/mL.
fmed-10-1147725-g0002.jpg
PMC10205987_01_fmed-10-1147725-g0002.jpg
F2
A 12-lead ECG revealed a hyperacute T wave with ST-segment elevations in leads V1-V4 and reciprocal ST-segment depressions in leads III and aVF (Figure 2).
Emergent coronary angiography (CAG) scan. (A) Right coronary artery with stenosis over the middle segment (red arrow). (B) Left anterior descending (LAD) artery with stenosis over the middle segment (red arrow). (C) Severe stenosis over the proximal LAD artery (white triangle). (D) Plain old balloon angioplasty (POBA) to the proximal LAD artery. Guidewire within the distal LAD artery and diagonal branch. (E) Follow-up angiography after the first POBA with residual stenosis. (F) Follow-up angiography after the second POBA and stent implantation (Orsiro 3.0 x 30 mm) without residual stenosis over the proximal LAD artery.
fmed-10-1147725-g0003.jpg
PMC10205987_01_fmed-10-1147725-g0003.jpg
F3
The patient had 50% mid-right coronary artery stenosis, 50% mid-LAD stenosis, and 90% proximal LAD stenosis (Figures 3A-C). TIMI 3 flow (full perfusion and normal flow) (Figures 3D-F). The procedure lasted for 62 min, and he was transferred to the intensive care unit.