If your LAD is 100% blocked, near the top which is the most common area, and you are typing in this forum, then I would assume you have developed collateral growth. This is where tiny vessels on the heart open up to give a feed into areas lacking in blood flow. Not everyone develops collateral growth, some people only develop enough vessels to feel comfortable at rest, some develop enough vessels not to ever know their LAD is blocked. What are your current symptoms and your limitations?
You do know how much better you would feel if you quit smoking? just try it for 48 hours and see the difference it makes.
Sorry, you asked the options and I didn't really answer the question.
First you need to make lifestyle changes. Second you need to get the right medication for your symptoms. If medication is sufficient then you could remain at this stage until things get worse, but hopefully they won't if you make the right lifestyle changes. If medication doesn't work well enough, then more aggressive intervention is required. You may be able to find a cardiologist willing to open the blockage and stent it. It depends on how long the blockage is, and how hard the plaque is. Failing this, you will require bypass surgery.
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