ABSTRACT
In light of contemporary data, it is remarkable to consider that balloon angioplasty was first performed for acute myocardial infarction just 20 years ago. At that time angioplasty was still very much in its infancy for the treatment of coronary artery disease. It is perhaps not surprising, therefore, that initial attempts to use angioplasty in evolving myocardial infarction were met with widespread criticism. In fact, few other therapies in medicine have generated as much debate and controversy as primary angioplasty. Since those early days, however, extraordinary advances have been made in the development of mechanical reperfusion for myocardial infarction. Many of these major milestones can be attributed to a small but highly dedicated group of investigators in this
field. On the basis of their pioneering work, catheter-based reperfusion has now emerged as the preferred reperfusion strategy for myocardial infarction. This chapter will review the key steps in the evolution of mechanical reperfusion as well as discuss the impact and limitations of primary percutaneous coronary intervention (PCI) in the current era.
