Cleaning arterial plaque, a process aimed at reducing and stabilizing plaque buildup in the arteries, is crucial for preventing cardiovascular events such as heart attacks and strokes. Here are some key strategies and treatments supported by recent medical research:

Lifestyle Changes
Diet: A heart-healthy diet, rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, can significantly impact plaque buildup. Reducing intake of saturated fats and trans fats helps lower cholesterol levels, vital in managing plaque.
Exercise: Regular physical activity helps improve cardiovascular health and can assist in reducing LDL cholesterol and raising HDL cholesterol, both of which are important for plaque management.

Medications
Statins: Statins are the most common medications prescribed for lowering cholesterol. They work by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver. Clinical studies have shown that high doses of statins can not only stabilize but also reduce plaque buildup. Patients with LDL cholesterol levels lowered below 70 mg/dL have seen up to a 24% regression in plaque​ (Cleveland Clinic)​.
PCSK9 Inhibitors: These newer medications, such as evolocumab (Repatha) and alirocumab (Praluent), are injectable drugs that significantly lower LDL cholesterol by inactivating a protein that interferes with the liver's ability to remove LDL from the blood. Studies, like the GLAGOV trial, have shown that adding PCSK9 inhibitors to statin therapy can lead to further reductions in LDL levels and a decrease in coronary plaque burden​ (Cleveland Clinic)​​ (Med Xpress)​.
Ezetimibe: This medication can be used alone or in combination with statins to further lower cholesterol levels. Ezetimibe works by reducing the absorption of cholesterol in the intestines.
Advanced Therapies
Bempedoic Acid: This drug is an oral medication that can be used alongside statins to further reduce LDL cholesterol. It works by inhibiting ATP citrate lyase, an enzyme involved in cholesterol synthesis.
Inclisiran: This is a small interfering RNA (siRNA) therapy that targets PCSK9 at the genetic level to reduce its production, leading to lower LDL cholesterol levels. It's administered as an injection every six months.
Surgical Interventions
Angioplasty and Stenting: These procedures are used to open blocked arteries. Angioplasty involves inflating a small balloon inside the artery to push plaque against the artery wall, and a stent (a small wire mesh tube) may be placed to keep the artery open.
Coronary Artery Bypass Grafting (CABG): In severe cases, bypass surgery is performed to create a new path for blood to flow around a blocked artery.
Monitoring and Follow-Up
Regular check-ups and monitoring are essential for managing and reducing arterial plaque. Non-invasive imaging techniques such as coronary CT angiography and intravascular ultrasound (IVUS) are used to assess plaque burden and guide treatment​ (Cleveland Clinic)​.

Overall, a combination of lifestyle changes, medications, and possibly surgical interventions, guided by regular medical evaluations, can effectively manage and reduce arterial plaque buildup, significantly lowering the risk of cardiovascular events.