Radial artery grafts vs saphenous vein grafts in coronary artery bypass surgery: a randomized trial

Area of Science:

• Cardiovascular Surgery
• Vascular Grafting
• Clinical Trials

Background:

• Arterial grafts are often preferred over saphenous vein grafts for coronary artery bypass grafting (CABG), drawing from the success of the left internal mammary artery.
• However, the comparative effectiveness of radial artery grafts remains less understood.

Purpose of the Study:

• To compare the 1-year angiographic patency rates of radial artery grafts versus saphenous vein grafts in patients undergoing elective CABG.
• To evaluate secondary outcomes including early graft patency, myocardial infarction, stroke, repeat revascularization, and mortality.

Main Methods:

• A multicenter, randomized controlled trial involving 757 participants undergoing first-time elective CABG.
• The left internal mammary artery was used for the left anterior descending artery, with other vessels randomized to receive either a radial artery or saphenous vein graft.
• The primary endpoint was graft patency assessed via angiography at 1 year post-CABG.

Main Results:

• Analysis included 733 patients, with 366 in the radial artery group and 367 in the saphenous vein group.
• No significant difference in graft patency was observed at 1 year: 89% for radial artery grafts versus 89% for saphenous vein grafts (P = .98).
• Secondary endpoints, including graft patency at 1 week, myocardial infarction, stroke, repeat revascularization, and death, also showed no significant differences between the groups.

Conclusions:

• In Veterans Affairs patients undergoing first-time elective CABG, radial artery grafts did not demonstrate superior 1-year patency compared to saphenous vein grafts.
• The findings suggest comparable efficacy between radial artery and saphenous vein grafts for CABG in this patient population.