Following an acute anterior myocardial infarction, a 56-yr-old female underwent two balloon angioplasty procedures for a recurrent proximal left anterior descending artery stenosis. She had recurrent angina pectoris. Angiography showed a noncritical restenosis with marked provocable superimposed vasospasm. Despite repeat balloon dilatation and stenting of the lesion, she developed recurrent symptoms. One month later, angiography showed progressive fixed disease and reversible spasm proximal and distal to, but not involving, the stented arterial segment. She underwent single-vessel coronary artery bypass grafting, and is asymptomatic at 6-mo follow-up.