ABSTRACT
The use of thrombolytic therapy has revolutionized the medical management of patients with acute myocardial infarction (AMI), increasing survival, and preserving left ventricular (LV) function. Despite these beneficial effects of fibrinolytic therapy, many limitations exist, such as high rates of persistent occluded vessel, recurrent ischemia, intracranial bleeding, and contraindications preventing its use. To improve these deficiencies, several strategies of myocardial reperfusion have emerged. In the last decade, the efficacy of primary angioplasty (mechanical reperfusion without prior thrombolysis) has been widely evaluated, and in the last few years other strategies, such as early rescue angioplasty (angioplasty for failed thrombolysis) and facilitated primary angioplasty (pharmacological reperfusion before angioplasty), have became areas of intense investigation.
