Improving STEMI Reperfusion with Intracoronary Thrombolysis: A Way to “Go with the Flow”

Keypoints: It is unclear what role, if any, intracoronary thrombolysis plays in the management of ST-segment elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PPCI). In this meta-analysis intracoronary thrombolysis-facilitated PPCI for STEMI was associated with improved outcomes compared to standard PPCI. A randomized controlled trial would be necessary to settle the question of whether intracoronary thrombolysis is a useful adjunct to PPCI and whether it is most effective before, during, or after PPCI.