Seventy-eight of 1,000 consecutive PTCA procedures were performed in the setting of acute MI. Twenty-four of 26 patients with subtotal coronary occlusions underwent successful PTCA, including 9 patients with and 15 patients without previous intracoronary streptokinase infusions. Of 52 patients with total occlusions, PTCA was performed after reperfusion by streptokinase in 24 patients, after unsuccessful intracoronary streptokinase infusion in 6 patients and without previous thrombolytic therapy in 14 patients (27%). Six patients (7.7%) died. The immediate post-PTCA course was stable in 59 of 63 successfully dilated patients and 4 had coronary reocclusion. Late catheterization (mean 10 days) in 41 patients showed improved left ventricular function in most. At 6.5 months of follow-up, there were 9 restenoses that required PTCA, 1 reocclusion, 1 elective CABG and no deaths.