• Medications (e.g. beta blockers, nitrates, statins).

  • Balloon angioplasty (percutaneous transluminal coronary angioplasty, or PTCA). A procedure in which the physician uses a balloon-tipped catheter to press plaque back against the artery wall to allow for better blood flow in the artery.

  • Coronary stenting. A small metal structure called a stent is inserted into the artery after angioplasty. Currently, stents are implanted in the majority of PTCA cases. The stent acts as scaffolding, keeping the artery wall stretched and maintaining adequate blood flow through the vessel. One of the risks in stenting and angioplasty is the re-narrowing (restenosis) of the artery. Ongoing attempts to prevent this complication include the development of stents coated with chemotherapeutic drugs that are released into the wall of the artery. Approved by the U.S. Food and Drug Administration in April 2003, such drug-eluting stents have demonstrated an ability to minimize restenosis to less than 10 percent of cases. This success rate has contributed to the rapid acceptance of drug-eluting stents and possibly contributed to a 25 percent drop in the number of bypass surgeries performed. One uncommon complication of stenting is subacute thrombosis. This is where the release of platelets causes blood clots to form within the stent, resulting in a re-narrowing of the artery. It can occur with both drug-eluting and “bare metal” stenting. Antiplatelet agents given in the months after stenting significantly reduce this risk.

  • Atherectomy. A catheter is inserted with a device on the tip that destroys and removes plaque. This procedure is generally reserved for extremely calcified plaque or complex cases of atherosclerosis.