Successive, rapid recurrences of in-stent restenoses in a woman with angina pectoris.

A 62-year-old woman was admitted because of chest pain. Coronary angiography demonstrated stenosis of the left anterior descending coronary artery, where two bare metal stents had been implanted. Over 5 months in-stent restenosis occurred four times, and was treated at first with angioplasty but finally with two sirolimus-eluting stent insertions. Six months after the second insertion, angiography showed restenosis within one stent. The mechanism underlying this succession of rapid restenoses is unknown, but sirolimus-eluting stents appeared to show relative resistance.