A 59-year-old man with grade III angina pectoris and 80% stenosis of the left anterior descending coronary artery developed an acute total occlusion of the artery during percutaneous transluminal coronary angioplasty (PTCA). Attempts at recanalisation and resuscitation were ineffective, and the patient died. The medico-legal autopsy revealed obstruction of left main coronary artery by a ringshaped piece of arterial wall that had been torn out of the femoral artery at the punction site and driven around the tip of the catheter into the orifice of the left coronary artery, filling it. This kind of complication of PTCA has not been described previously.