A 60-year-old male cigarette smoker with hypertension and hyperlipidaemia underwent coronary artery bypass surgery after hospitalization for unstable angina. An in situ, pedicled, left internal mammary artery (LIMA) was grafted to the left anterior descending (LAD) artery, and vein grafts were placed to the right posterior descending and obtuse marginal arteries. One month later, the patient underwent repeat angiography for severe angina; this revealed patent vein grafts and a significant LIMA stenosis at the site of a kink ( Fig. 1 ), which was refractory to selective catheter injection of nitroglycerine. Because no other possible culprit lesion was revealed, we intervened directly with deployment of a 3.0 mm × 15 mm everolimus-eluting stent across the kink site. This led to complete resolution of the stenosis; sustained relief of angina was confirmed at 1-year follow-up.
