Hi Shalahuddin,

To answer your question, we might go back to the pathophysiology of venous and arterial thrombotic disorders. In case of an arterial thrombosis, for the longest time we are holding notion that it is largely due to an occurrence of platelet activation, whereas venous thrombosis is mostly a concern of activation of the clotting cascade, please see (PMID: 27628000) for interesting discussion. To develop Catheter application for Directed Thrombolysis for Coronary Arteries, we would have to do more research on this topic as a typical thrombus consists of a variable proportion of fibrin, platelets, red blood cells, white blood cells, von Willebrand factor (vWF) and extracellular DNA (PMID:31048352). We would have to use directed thrombolysis for a specific clot in the coronary artery, as there would be much higher risk for bleeding (especially intracranial), if directed thrombolysis has missed the target-clot-composition and instead through an immediate coronary drainage escaped into systemic circulation causing e.g., hemorrhagic stroke.

Your question addresses the concept of coronary reperfusion in an attempt to salvage myocardium following coronary occlusion. During the early 1980's streptokinase was the first thrombolytic agent used and it was delivered by a Judkins coronary artery catheter. Subsequently, thrombolytics were found to be safe and effective when given intravenously, so no one continued the riskier intracoronary perfusion approach. It ended in the mid to late 1980s.

The short answer is that it has already been done and abandoned in favor of alternative means.