Restenosis and accelerated left main coronary artery disease presenting six months after successful percutaneous transluminal coronary angioplasty.

Percutaneous transluminal coronary angioplasty (PTCA) is widely used to achieve myocardial revascularization because of its high success rate and low rate of complications. A 30% rate of restenosis remains the most serious hurdle to overcome. This phenomenon results from endothelial injury caused by balloon inflation. However, not widely appreciated is that other components of PTCA equipment can cause endothelial injury and lead to new stenoses proximal to the dilated lesion. This phenomenon has serious implications when it involves the left main artery. Described here is a case of restenosis involving the left anterior descending artery as well as accelerated left main disease.