Backgrounds : Concerns have been raised about the long-term efficacy and safety of drug-eluting stents (DES). We postulated that suppression of neointimal hyperplasia by DES may be temporary and a ���late catch-up��� (LCU) phenomenon in restenosis may observed. Objectives : We sought to describe several cases of ischemic-driven late target lesion revascularization (TLR) after implantation of DES due to LCU and examined the clinical and angiographic characteristics of them. Methods : From October 2003 to May 2006, we reviewed the coronary angiogram (CAG) and collected LCU cases after implantation of DES from 2 cardiovascular centers retrospectively. LCU was defined as 1) no significant restenosis on routine follow-up CAG after implantation of DES, 2) newly developed ischemic symptoms and/or evidences of myocardial ischemia on stress tests (Treadmil or thallium perfusion scan) beyond the first six to nine months after the routine follow-up CAG, 3) significant restenosis in the previously stented target lesion on ischemic-driven follow-up CAG. Results : Eighteen segments of LCU were detected in 18 patients (men, 12: mean age, 58.8짹13.2 years). Mean follow-up duration of LCU was 24.9짹11.5 months. seventeen (94.4%) were sirolimus-eluting stent (SES) and one (5.6%) was paclitaxel-eluting stent (PES). 11/18 (61.1%) of LCU segments were located in left anterior descending artery and followed as right coronary (16.7%), left circumflex (11.1%) and ramus intermedius artery (11.1%). In patterns of neointimal growth, 11/18 (61.1%) were focal restenosis and 9/11 (81.8%) were stent-marginal restenosis. On quantitative coronary analysis, the late loss and percent diameter stenosis (%DS) at ischemic-driven follow-up CAG was significantly higher than those at routine follow-up CAG (late loss; 0.30mm vs. 2.02mm, p<0.001: %DS; 18.1% vs. 3.2%, p<0.001). Conclusions : LCU phenomenon may be a considerable late complication after DES implantation, especially after SES implantation.