Revascularization of the Infarct-related Artery: Never Too Late?

During the early phase of an acute myocardial infarction (MI), current consensus is that reperfusion of the infarct-related artery (IRA) should be implemented as soon as possible, more effectively accomplished via percutaneous coronary intervention (PCI). The clinical approach to the occluded IRA late after MI remains controversial, but current practice shows a strong trend in favor of PCI, which is based on the late open artery hypothesis. However, late PCI on IRAs also has the potential for harm from procedure-related complications. An attempt is made herein to critically overview the current data on this important topic, mainly based on recent meta-analyses with somewhat diverging results, indicating that clinical judgment and an individualized approach still remains a valid guide