Revascularisation strategies for acute myocardial infarction have evolved from early admission to coronary care units, bed rest and cardiac rhythm monitoring, to thrombolytic therapy and primary angioplasty. Although mechanical intervention for a failed prior revascularisation attempt is common widespread clinical practice, the outcome of this two-step modality may yet be an issue of debate. The available evidence is selected and reviewed within a clinical reference framework. This enables the presentation of a practical model for all stakeholders participating in cardiovascular care.