IACP has played an important role in the evolution of the therapy of cardiogenic shock. Although IACP has not developed to an independent treatment modality, it is an essential adjunct to facilitate early catheterization and reperfusion strategies. With this combined approach, hospital and long-term survival rates have reached encouraging results. In acute myocardial infarction, IACP may evolve into an intriguing adjunct to thrombolysis and/or PTCA. Preliminary data suggest that IACP might decrease the rate of reocclusion and reinfarction after thrombolysis and/or PTCA and, thus, interrupt the vicious cycle of infarct extension, development of left-ventricular failure and cardiogenic shock. Further research is in progress.