A 78-year-old man was admitted with a history of class 3 Canadian cardiovascular society CCS grading of angina seven year after an angioplasty of mid left anterior descending artery with a 2,5x18mm Sirolimus drug eluting stent (Cypher) for unstable angina. Coronary angiography showed focal in-stent restenosis. Balloon angioplasty was planned as initial strategy motivated by the focal pattern of restenosis in a small diameter stent with thick struts.
