We present a case of restenosis of a sirolimus drug-eluting stent in the ostium of the right coronary artery due to severe crimping and underexpansion of the stent in an area of heavy calcification, detected by intracoronary ultrasound but not by angiography. We discuss issues relevant to management of the restenotic drug-eluting stent in the aorto-ostial location. (c) 2006 Wiley-Liss, Inc.