In-stent restenosis (ISR) accounts for 10–12 % of all percutaneous coronary interventions (PCI) performed in the U.S. today [ ]. Repeat PCI for ISR is associated with an increased incidence of major adverse cardiovascular and cerebrovascular events including myocardial infarction and recurrent revascularization when compared to PCI of de-novo coronary lesions [ ]. Even non- emergency, uncomplicated ISR target lesion revascularization (TLR) by re-stenting (stent overlap) is associated with an increased risk for myocardial infarction and death through 5-year follow-up [ ] and the optimal duration of dual antiplatelet therapy following re-stenting is poorly defined [ ].