In-stent-stenosis of a bare-metal stent 11 years after its implantation

History and admission findings: A 52-year-old man was admitted to our hospital with unstable angina pectoris. A balloon angioplasty of his left anterior descending artery had been performed 12 years ago and two bare-metal stents had been implanted two months later for an early restenosis. Diagnostic procedures: Bicycle ergometry was stopped because the patient experienced angina pectoris and the electrocardiogram showed ST-segment depression in leads V4-V6. Treatment and outcome: A coronary angiography was performed and a single-vessel disease with a significant in-stent stenosis of the proximal left anterior descending artery was diagnosed. Another successful percutaneous coronary intervention was performed with implantation of a drug-eluting stent. The further hospital course was uneventful. Conclusion: Even after more than 11 years an in-stent stenosis of a bare-metal stent can occur without progression of coronary artery disease in the other coronary arteries.