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Radial artery versus saphenous vein patency randomized trial: five-year angiographic follow-up

Peter Collins1, Carolyn M Webb, Chee F Chong

  • 1Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College London, London, UK.

Circulation
|May 29, 2008
PubMed

Insights

Radial artery grafts show superior 5-year patency compared to saphenous vein grafts in coronary artery bypass surgery. This finding supports the radial artery as a durable option for improving long-term patient survival.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Grafting
  • Interventional Cardiology

Background:

  • Graft patency is crucial for long-term survival after coronary artery bypass surgery.
  • Internal thoracic artery grafts exhibit superior patency over saphenous vein grafts.
  • Limited data exists on the midterm and long-term patency of radial artery grafts.

Purpose of the Study:

  • To compare the 5-year angiographic patency of radial artery versus saphenous vein grafts in aortocoronary bypass surgery.
  • To evaluate graft narrowing rates between radial artery and saphenous vein conduits.
  • To assess the radial artery as a viable alternative for coronary revascularization.

Main Methods:

  • A single-center prospective randomized trial was conducted.
  • 142 patients were randomized to receive either radial artery or saphenous vein grafts.
  • Angiographic graft patency was assessed at 5 years postoperatively.

Main Results:

  • At 5 years, 98.3% of radial artery grafts and 86.4% of saphenous vein grafts remained patent (P=0.04).
  • Graft narrowing was significantly lower in radial artery grafts (10%) compared to saphenous vein grafts (23%) (P=0.01).
  • The 5-year survival rate for eligible patients was 94.4%.

Conclusions:

  • Radial artery grafts demonstrate excellent 5-year patency rates when used for aortocoronary bypass to the circumflex artery.
  • The patency of radial artery grafts is significantly better than saphenous vein grafts at 5 years.
  • Radial artery grafts offer comparable patency to internal thoracic artery grafts, establishing them as a reliable option.
Abstract

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