Coronary angiography was performed 2 hours after onset of complaints in a 57-year-old patient with acute anteroseptal infarction. Using a wire spiral in the coronary catheter the acutely occluded anterior interventricular branch was reopened. With intracoronary streptokinase (120 000 units in 50 minutes) the recanalisation canal was enlarged. The clinical picture and electrocardiographic findings improved under the influence of treatment. An aorto-coronary bypass operation was performed on the following day. The post-operative angiogram showed marked improvement of left ventricular function. The results indicate that this intervention prevented widespread necrosis.