A case of Takayasu arteritis with left main disease is described. Intrastent restenosis occurred one year after the first percutaneous coronary angioplasty (PCI) with a drug-eluting stent (everolimus). After suppression of the active disease with immunosuppressive therapy, and sirolimus added, a second PCI were performed with zotarolimusbased DES, after pre-dilatation with paclitaxel-based balloon angioplasty. Control coronary angiography with optic coherence tomography performed two months later confirmed no restenosis. This is the first case of effective local use of two different antiproliferative agents during angioplasty and effective systemic use of sirolimus in
Takayasu’s disease with coronary involvement.