Intracoronary treatment in acute myocardial infarction seems to be useful in order (1) to reach the maximum rate of reperfusion, (2) to reduce rate of reocclusion and reinfarction, and (3) to improve coronary blood flow necessary to maximize salvage of myocardium. Particularly in patients with cardiogenic shock and right ventricular infarction, PTCA in addition to thrombolytic therapy seems to be a major improvement of therapy. Whether intracoronary therapy including PTCA is superior to intravenous thrombolytic therapy with elective PTCA will hopefully be answered in cooperative studies.