Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 0 0 2024 09 07 2117 2117 EN Rajesh Vijayvergiya Post Graduate Institute of Medical Education and Research, Chandigarh Arghadip Bose Post Graduate Institute of Medical Education and Research, Chandigarh Lipi Uppal Post Graduate Institute of Medical Education and Research, Chandigarh Basant Kumar Post Graduate Institute of Medical Education and Research, Chandigarh Bhupendra Sihag Post Graduate Institute of Medical Education and Research, Chandigarh Ankush Gupta Post Graduate Institute of Medical Education and Research, Chandigarh 2024 07 02 2024 11 07 Background: In-stent restenosis (ISR) following percutaneous coronary intervention (PCI) is an unwanted complication in some patients. The etiology is multifactorial, and identifying these factors may help improve long-term outcomes after PCI. Case summary: We hereby describe two cases of recurrent ISR; case 1 describes the techniques of PCI used over 17 years to manage recurrent ISR of Left Main bifurcation disease, while case 2 highlights the role of coronary artery bypass grafting (CABG) as a treatment modality for recurrent ISR of the right coronary artery. Discussion: Management of post-PCI recurrent ISR has witnessed multiple advancements over the past decade. Newer technologies like intravascular imaging, plaque or calcium modification techniques, and drug-eluting balloons enable effective management of recurrent ISR.  This article describes possible risk factors for recurrent ISR and discusses various treatment strategies for its management. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2117