ABSTRACT
A compelling question confronting clinicians is how to optimally treat acute ST segment elevation myocardial infarction (STEMI). Over the past several decades, it has become clear that early recanalization of the infarct-related artery (IRA) is pivotal. How to best achieve this objective remains hotly debated. Some argue that thrombolysis is the preferred modality. Others promulgate primary percutaneous coronary intervention (PCI). Some advocate a combination, conventionally denoted as facilitated PCI. However, thrombolysis does not literally facilitate PCI. It may, in fact, render it more difficult. Furthermore, the combination deserves to be denoted as a specific entity with attributes that may be synergistic. Thus, we shall refer to the combination as pharmacoinvasive therapy. To better understand the potential synergies of thrombolysis and acute infarct PCI, it is instructive to carefully consider the evolution of recanalization therapy itself.
