The SALINE Technique for the Treatment of the No-Reflow Phenomenon during Percutaneous Coronary Intervention in STEMI.
SALINE technique
STEMI
no-reflow
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
21 Mar 2023
21 Mar 2023
Historique:
received:
16
02
2023
revised:
10
03
2023
accepted:
15
03
2023
medline:
30
3
2023
entrez:
29
3
2023
pubmed:
30
3
2023
Statut:
epublish
Résumé
Primary percutaneous coronary intervention (pPCI) performed for STEMI may be complicated by the "no-reflow" phenomenon. 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). 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. 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%), ( 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.
Sections du résumé
BACKGROUND
BACKGROUND
Primary percutaneous coronary intervention (pPCI) performed for STEMI may be complicated by the "no-reflow" phenomenon.
AIMS
OBJECTIVE
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
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
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%), (
CONCLUSIONS
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.
Identifiants
pubmed: 36983405
pii: jcm12062405
doi: 10.3390/jcm12062405
pmc: PMC10057061
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Eur Heart J. 2018 Jan 7;39(2):119-177
pubmed: 28886621
J Interv Cardiol. 2021 Jun 02;2021:9971874
pubmed: 34149324
Atherosclerosis. 2022 Jul;352:46-52
pubmed: 35667163
Cardiovasc Res. 2019 Jun 1;115(7):1143-1155
pubmed: 30428011
Nat Clin Pract Cardiovasc Med. 2006 Sep;3(9):499-506
pubmed: 16932767
Circulation. 2004 Nov 23;110(21):e506-10
pubmed: 15557381
Circ Cardiovasc Interv. 2017 Apr;10(4):
pubmed: 28400462
J Am Coll Cardiol. 2018 Oct 30;72(18):2231-2264
pubmed: 30153967
Eur Heart J. 2009 Mar;30(5):594-9
pubmed: 19168868
Lancet. 2008 Jun 7;371(9628):1889-90
pubmed: 18539205
EuroIntervention. 2021 Oct 01;17(8):e672-e679
pubmed: 33528358
N Engl J Med. 2008 Feb 7;358(6):557-67
pubmed: 18256391
Circulation. 2002 Apr 23;105(16):1909-13
pubmed: 11997276
JACC Cardiovasc Imaging. 2019 May;12(5):837-848
pubmed: 29680355
Circ Res. 2016 May 13;118(10):1643-58
pubmed: 27174955
JACC Cardiovasc Interv. 2013 Jun;6(6):580-9
pubmed: 23683738
J Am Heart Assoc. 2020 Aug 4;9(15):e015793
pubmed: 32689859
Circulation. 1994 Jun;89(6):2514-8
pubmed: 8205658
J Am Coll Cardiol. 1997 Nov 1;30(5):1193-9
pubmed: 9350914
J Am Coll Cardiol. 2015 Apr 14;65(14):1454-71
pubmed: 25857912
JAMA. 2005 Apr 13;293(14):1759-65
pubmed: 15827315
Curr Vasc Pharmacol. 2020;18(3):262-272
pubmed: 31092181
J Am Coll Cardiol. 2016 Apr 12;67(14):1674-83
pubmed: 27056772
JACC Cardiovasc Interv. 2021 Mar 22;14(6):595-605
pubmed: 33736767
Catheter Cardiovasc Interv. 2021 Mar;97(4):602-611
pubmed: 32678493
Circulation. 2016 Mar 15;133(11):1135-47
pubmed: 26490017
Lancet. 2008 Jun 7;371(9628):1915-20
pubmed: 18539223
J Am Heart Assoc. 2021 Feb 2;10(3):e018562
pubmed: 33459027
Eur Heart J. 2007 Jun;28(12):1433-9
pubmed: 17556347
J Am Coll Cardiol. 2000 Oct;36(4):1202-9
pubmed: 11028471