The technique of Percutaneous Coronary Intervention (PCI) has improved considerably over the last decades. Important developments have been the introduction of stents and better anticoagulation treatment. PCI is used most commonly in the treatment of unstable angina pectoris or non ST-elevation myocardial infarction. In Sweden today, more than half of the patients with ST-elevation myocardial infarction are treated primarily with PCI. Despite the high degree of opening of the infarct-related artery, the reduction in mortality is modest compared with treatment with thrombolysis indicating that there is room for considerable improvement. There is a need for randomised studies of adjunctive therapies but it can be speculated that thrombectomy devices and specific reperfusion injury therapy might reduce mortality in PCI treatment of ST-elevation myocardial infarction.