3rd June 2026

Surgical/ Interventional management

Coronary Artery Disease

• Percutaneous Coronary Intervention (PCI) – Utilised in acute coronary syndrome (ACS) or for angina not controlled by medical therapy 
• Coronary Artery Bypass Grafting (CABG) – Utilised when plaques block coronary arteries, usually in complex blockages, unstable or uncontrolled angina. It involves bypassing the blood flow with arterial or venous conduits. The most commonly used vessel for a conduit is the left internal thoracic artery (ITA) due to its patency over long time periods. The radial artery and saphenous vein are also used frequently, however may be less patent in the long term.

Carotid disease

• Carotid Endarterectomy (CEA) – This involves the removal of cholesterol deposits and clots in the artery wall. Utilised for symptomatic carotid stenosis above 70%, however may be beneficial for patients with 50-69% stenosis. When performed in asymptomatic stenosis, the risk of any stroke is reduced by 30% over the next 3 years.
• Carotid Stenting – Utilised if there is severe stenosis plus co-morbidities, high surgical risk or contraindications to endarterectomy.

Peripheral Arterial Disease

• Treatment depends on severity. 
• Angioplasty or bypass surgery – if there are persistent symptoms or critical limb ischaemia 
• Amputation – In non-reconstructable ischaemia or severe infection