A 72-year-old man with effort angina due to frequent in-stent restenosis (ISR) was transferred to our institution. The present target was the ISR of the middle left anterior descending artery (LAD) with fractional flow reverse of 0.67; a bare metal stent and drug-eluting stent were implanted 13 and 2 years before the current admission, respectively. Moreover, plain old balloon angioplasty had failed with severe balloon indentation a month ago at the previous hospital. First angiography showed severe LAD stenosis due to stent under-expansion. Optical coherence tomography (OCT) revealed double-layered stent under-expansion. Thereafter, excimer laser coronary angioplasty (ELCA, X-80, USA, Spectranetics) “without” the saline flushing technique at 80 J and 80 Hz was performed to modify the calcium-plaque located underneath the stents. The indentation disappeared during the dilatation of a 3.0-mm non-compliant balloon with 24 atm and 3.0-mm drug-eluting balloon. Final angiography showed no residual stenosis; OCT showed enough stent expansion and cracked calcification behind the previously implanted stent. At 3 months after this procedure, the patient had remained uneventful.