Abstract
We report a case of a 63-year-old male with a history of multiple percutaneous coronary interventions (PCIs) and diabetes mellitus, presenting with exertional angina of 3 months duration. Coronary angiography revealed in-stent restenosis (ISR) in the right coronary artery (RCA) with heavily calcific disease. Given the severity of symptoms and lesion complexity, the patient underwent laser-assisted percutaneous coronary intervention using excimer laser. Successful revascularization was achieved with drug-eluting stent (DES) implantation under intravascular ultrasound (IVUS) guidance. This case underscores the importance of individualized treatment strategies, advanced hardware selection, and the role of excimer laser in ISR management.