Initially Coronary Artery Disease (CAD) can be treated with tablets that can increase blood supply to the heart muscles either by dilating the blood vessels or making the heart pump the blood slowly but with more force. Aspirin or Anti-platelet therapy is given to keep the blood thin and prevent thrombosis. Medications are also given to reduce cholesterol/lipids levels in the blood and control diabetes and hypertension.
Angioplasty is an alternate invasive procedure to CABG, where the blocked arteries are opened up using a balloon catheter followed usually by metal ring like stent (resembles a coiled spring) to keep the opening from closing up again.
Patients with left main coronary artery stenosis or severe triple vessel disease (where all the 3 main coronary arteries have plaques) may not be eligible for a Percutaneous Transluminal Coronary Angioplasty (PTCA).
Patients on high dose medications who continue to experience symptoms create a need for surgical intervention to remove or by-pass the blockages. In certain situation as described above the patient may not be fit for PTCA due to the nature of the disease and it is then that CABG is recommended.