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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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Autores principales: Grancini, Luca, Diana, Davide, Centola, Alice, Monizzi, Giovanni, Mastrangelo, Angelo, Olivares, Paolo, Montorsi, Piero, Alushi, Brunilda, Bartorelli, Antonio L., Galassi, Alfredo R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10057061/
https://www.ncbi.nlm.nih.gov/pubmed/36983405
http://dx.doi.org/10.3390/jcm12062405
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author Grancini, Luca
Diana, Davide
Centola, Alice
Monizzi, Giovanni
Mastrangelo, Angelo
Olivares, Paolo
Montorsi, Piero
Alushi, Brunilda
Bartorelli, Antonio L.
Galassi, Alfredo R.
author_facet Grancini, Luca
Diana, Davide
Centola, Alice
Monizzi, Giovanni
Mastrangelo, Angelo
Olivares, Paolo
Montorsi, Piero
Alushi, Brunilda
Bartorelli, Antonio L.
Galassi, Alfredo R.
author_sort Grancini, Luca
collection PubMed
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%), (p < 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%), (p < 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 (p = 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.
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spelling pubmed-100570612023-03-30 The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI Grancini, Luca Diana, Davide Centola, Alice Monizzi, Giovanni Mastrangelo, Angelo Olivares, Paolo Montorsi, Piero Alushi, Brunilda Bartorelli, Antonio L. Galassi, Alfredo R. J Clin Med Article 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%), (p < 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%), (p < 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 (p = 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. MDPI 2023-03-21 /pmc/articles/PMC10057061/ /pubmed/36983405 http://dx.doi.org/10.3390/jcm12062405 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Grancini, Luca
Diana, Davide
Centola, Alice
Monizzi, Giovanni
Mastrangelo, Angelo
Olivares, Paolo
Montorsi, Piero
Alushi, Brunilda
Bartorelli, Antonio L.
Galassi, Alfredo R.
The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10057061/
https://www.ncbi.nlm.nih.gov/pubmed/36983405
http://dx.doi.org/10.3390/jcm12062405
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