The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI
Background: Primary percutaneous coronary intervention (pPCI) performed for STEMI may be complicated by the “no-reflow” phenomenon. Aims: A super-selective intracoronary injection of saline solution through a thrombus aspiration catheter (SALINE technique), was investigated for the treatment of no-r...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/6/2405 |
| _version_ | 1797610921955164160 |
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| author | Luca Grancini Davide Diana Alice Centola Giovanni Monizzi Angelo Mastrangelo Paolo Olivares Piero Montorsi Brunilda Alushi Antonio L. Bartorelli Alfredo R. Galassi |
| author_facet | Luca Grancini Davide Diana Alice Centola Giovanni Monizzi Angelo Mastrangelo Paolo Olivares Piero Montorsi Brunilda Alushi Antonio L. Bartorelli Alfredo R. Galassi |
| author_sort | Luca Grancini |
| collection | DOAJ |
| description | Background: Primary percutaneous coronary intervention (pPCI) performed for STEMI may be complicated by the “no-reflow” phenomenon. Aims: A super-selective intracoronary injection of saline solution through a thrombus aspiration catheter (SALINE technique), was investigated for the treatment of no-reflow as compared with the standard care of therapy (SCT). Methods: Among the 1471 patients with STEMI undergoing pPCI between May 2015 and June 2020, 168 patients developed no-reflow. Primary endpoints were the incidence of ST-segment resolution (STR) ≥ 70% at 90 min after PCI and the rate of flow restoration (TIMI flow grade 3 with an MBG > 1). The secondary endpoint was the incidence of major adverse cardiac and cerebrovascular events at 3 years follow-up. Results: After propensity score matching analysis, patients treated with SALINE showed STR ≥ 70% in twelve out of the sixteen patients (75.0%), compared to only three patients out of the sixteen in the SCT control group (19.0%), (<i>p</i> < 0.004). SALINE was associated with a higher probability of final TIMI flow grade 3 with an MBG > 1, as shown in fourteen out of sixteen patients (87.5%), as compared to only seven out of sixteen patients in the SCT group (43.8%), (<i>p</i> < 0.03). MACCE at 3 years follow-up occurred in only one patient (6.3%) in the SALINE group, as compared to eight patients (50%) in the SCT group (<i>p</i> = 0.047). Conclusions: The SALINE technique showed to be a safe and effective strategy to reduce “no-reflow” in STEMI patients as assessed by significant STR, improvement of TIMI flow grade, and better 3-year outcomes. |
| first_indexed | 2024-03-11T06:21:43Z |
| format | Article |
| id | doaj.art-09080590cbc84ae0b4f5718188e320fb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T06:21:43Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-09080590cbc84ae0b4f5718188e320fb2023-11-17T11:52:25ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01126240510.3390/jcm12062405The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMILuca Grancini0Davide Diana1Alice Centola2Giovanni Monizzi3Angelo Mastrangelo4Paolo Olivares5Piero Montorsi6Brunilda Alushi7Antonio L. Bartorelli8Alfredo R. Galassi9Ospedale Galeazzi Sant’Ambrogio, IRCCS, 20157 Milan, ItalyDepartment of Promise, University of Palermo, 90133 Palermo, ItalyCentro Cardiologico Monzino, IRCCS, 20138 Milan, ItalyOspedale Galeazzi Sant’Ambrogio, IRCCS, 20157 Milan, ItalyOspedale Galeazzi Sant’Ambrogio, IRCCS, 20157 Milan, ItalyCentro Cardiologico Monzino, IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino, IRCCS, 20138 Milan, ItalyDepartment of Cardiology, Campus Benjamin Franklin, Charite’ Medical University Berlin, 12203 Berlin, GermanyOspedale Galeazzi Sant’Ambrogio, IRCCS, 20157 Milan, ItalyDepartment of Promise, University of Palermo, 90133 Palermo, ItalyBackground: Primary percutaneous coronary intervention (pPCI) performed for STEMI may be complicated by the “no-reflow” phenomenon. Aims: A super-selective intracoronary injection of saline solution through a thrombus aspiration catheter (SALINE technique), was investigated for the treatment of no-reflow as compared with the standard care of therapy (SCT). Methods: Among the 1471 patients with STEMI undergoing pPCI between May 2015 and June 2020, 168 patients developed no-reflow. Primary endpoints were the incidence of ST-segment resolution (STR) ≥ 70% at 90 min after PCI and the rate of flow restoration (TIMI flow grade 3 with an MBG > 1). The secondary endpoint was the incidence of major adverse cardiac and cerebrovascular events at 3 years follow-up. Results: After propensity score matching analysis, patients treated with SALINE showed STR ≥ 70% in twelve out of the sixteen patients (75.0%), compared to only three patients out of the sixteen in the SCT control group (19.0%), (<i>p</i> < 0.004). SALINE was associated with a higher probability of final TIMI flow grade 3 with an MBG > 1, as shown in fourteen out of sixteen patients (87.5%), as compared to only seven out of sixteen patients in the SCT group (43.8%), (<i>p</i> < 0.03). MACCE at 3 years follow-up occurred in only one patient (6.3%) in the SALINE group, as compared to eight patients (50%) in the SCT group (<i>p</i> = 0.047). Conclusions: The SALINE technique showed to be a safe and effective strategy to reduce “no-reflow” in STEMI patients as assessed by significant STR, improvement of TIMI flow grade, and better 3-year outcomes.https://www.mdpi.com/2077-0383/12/6/2405STEMIno-reflowSALINE technique |
| spellingShingle | Luca Grancini Davide Diana Alice Centola Giovanni Monizzi Angelo Mastrangelo Paolo Olivares Piero Montorsi Brunilda Alushi Antonio L. Bartorelli Alfredo R. Galassi The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI Journal of Clinical Medicine STEMI no-reflow SALINE technique |
| title | The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI |
| title_full | The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI |
| title_fullStr | The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI |
| title_full_unstemmed | The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI |
| title_short | The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI |
| title_sort | saline technique for the treatment of the no reflow phenomenon during percutaneous coronary intervention in stemi |
| topic | STEMI no-reflow SALINE technique |
| url | https://www.mdpi.com/2077-0383/12/6/2405 |
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