Evaluating Noninvasive Venous Stasis Before Primary PCI to Improve Artery Reopening in STEMI Patients The RE-START STEMI Randomized Trial

What this Trial Is About

Researchers are evaluating a noninvasive artificial venous stasis procedure called RE-START to see if it increases spontaneous reperfusion in patients with acute ST Elevation Myocardial Infarction STEMI before they undergo primary percutaneous coronary intervention PCI. The study examines whether temporarily restricting venous return using a blood pressure cuff on the non-dominant arm can stimulate natural clot breakdown and improve blood flow in the affected coronary artery without delaying standard care. Participants undergo the RE-START procedure, which involves short-term controlled venous return restriction applied prior to primary PCI. The study compares the rate of spontaneous reperfusion, defined by specific blood flow grades, between those receiving the RE-START procedure and those undergoing a sham or control procedure. This intervention is administered without delaying the usual preparation or treatment process for PCI. During the study, participants are monitored for the presence of spontaneous coronary reperfusion before PCI, ST-segment resolution 90 minutes after PCI, left ventricular function within 48 hours, blood markers related to clot breakdown and heart stress, and kidney function after PCI. The study includes assessments from baseline through hospital discharge. Participants must be hemodynamically stable adults with confirmed STEMI and scheduled for primary PCI, and the study tracks outcomes related to heart and kidney health as well as procedure safety.

Noninvasive Artificial Venous Stasis for Reperfusion in STEMI