You may think of arteries like pipes. Sometimes pipes become partially blocked by substances like lime scale, making them look like this:
If you put acid or some other chemicals through the pipes, it dissolves the lime scale and the pipe is restored.
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So why doesn’t something like this work on the heart?
The problem is that the buildup in the artery isn’t on the inside. Instead, it’s within the wall of the vessel. The fatty buildup is called atheroma:
Blood vessels are lined with cells called endothelium. The endothelium covers up the atheroma. Nothing you put in your blood will “dissolve” the atheroma, because it would need to get past the endothelium first.
You can’t give something that will remove the endothelium, because endothelium is vital to your survival.
For very large arteries, a surgeon can operate to remove atheroma in a procedure called an Endarterectomy. But the coronary arteries are too small for this. So for coronary atheroma, stents can be employed to stretch open the blocked segments and hold them open with wire mesh:
Even then, endothelium starts to form over the inner surface of the stent, and then fresh atheroma starts to be deposited inside the stent. This process can be substantially slowed with medications.
