A case report describes a drug-coated balloon rescuing a single-function coronary graft during Impella-protected PCI when a stent could not be delivered. In a 77-year-old man with the only functioning LIMA-to-LAD graft, full coronary flow was reportedly restored after the balloon strategy. While the report is not comparative evidence, it highlights a practical interventional contingency: using drug-coated balloons to salvage critical lesions when stent delivery is technically constrained. For centers running complex PCI programs, the clinical implication is that balloon-based options may support procedural flexibility in high-stakes graft anatomy. The key limitation remains generalizability, but the vignette may influence how operators plan backup strategies for graft-dependent patients.