Enhanced external counterpulsation (EECP) is an effective noninvasive treatment for chronic stable angina.Despite intensive risk factor modification,a patient required two surgical coronary revascularizations and seven multivessel angioplasties over a 26-month period,demonstrating recurrent unstable angina and persistent thallium perfusion defects despite revascularization.Post EECP,angina was relieved,thallium defects were resolved and the patient has remained asymptomatie for 36 months.