Star Striker

In Star Striker there's no power ups, your ship fires a broad forward shot and homing missiles when there's something to target. You don't have a conventional number of lives, either, with a score deduction for dying followed by immediate respawn. The enemies come in fast, the screen is relatively small (and for some reason, you can't use the very top of it) and there's not really an offscreen area to the side. Although not quite as busy as say, a bullet hell shooter, it use just about every symbol and color for enemy shots, that can make them rather hard to track amongst all the action.