What is the role of invasive intervention after coronary thrombolysis ?

Intervention to improve coronary flow after coronary patency has been restored by coronary thrombolysis is attractive in concept, but has been proved disappointing in practice. A number of randomized clinical trials which compared outcome after thrombolysis with and without early or delayed intervention has shown no benefit towards intervention in terms of survival or other clinical measurements. This may partly reflect the imperfection of current intervention techniques, particularly a high re-occlusion rate, and partly as yet unsolved problems of myocardial preservation. Revascularization does have an important role in patients who develop recurrent ischaemia after thrombolysis, or in patients with multi-vessel disease who initially present as myocardial infarction patients.