In the past few years important progress has been made in the field of catheter-based reperfusion for acute ST elevation myocardial infarction (MI). In addition to the emergence of stent implantation as the treatment of choice, important emphasis has been placed on the critical role of preserving an intact microcirculation and pharmacological regimens have evolved to bridge to and facilitate mechanical reperfusion. These innovations will be discussed after a brief review of the key differences between reperfusion strategies, history of catheter-based reperfusion, and its comparison with fibrinolysis.

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