The results of several randomised trials have shown superior outcomes with primary angioplasty for acute myocardial infarction compared to thrombolytic treatment.1-4 Primary angioplasty establishes TIMI-3 flow in the infarct artery in 93–97% of patients1 5 compared with 54% with accelerated t-PA.6 Pooled data from three randomised trials have shown lower hospital mortality (2.2% v 5.9%, p = 0.02) and less non-fatal re-infarction (1.9% v 8.1%, p = 0.001) in patients treated with primary angioplasty versus thrombolytic treatment.1-3 Intracranial haemorrhage, the most feared complication of thrombolysis, occurred significantly less often with primary angioplasty versus t-PA in both the PAMI-1 trial (0% v 2.0%, p = 0.05)1 and the GUSTO-IIB trial (0% v 1.4%, p = 0.008).4 In addition, several studies have documented shorter hospital stay and comparable or lower hospital costs with primary angioplasty.7-9 Because of these data, primary angioplasty has emerged as the preferred reperfusion strategy for acute myocardial infarction in institutions with interventional facilities and skilled operators.