Radial artery versus saphenous vein patency randomized trial: five-year angiographic follow-up.
BACKGROUND
Graft patency is a fundamental predictor of long-term survival after coronary artery bypass surgery. Left and right internal thoracic artery (arterial) graft patency has been shown to be superior to that of saphenous vein grafts. More recently, the radial artery has been used as an aortocoronary graft, but little is known about the midterm and long-term patency of this conduit. We performed a single-center prospective randomized trial comparing the angiographic patency of radial artery and saphenous vein aortocoronary bypass grafts at 5 years after surgery.


RESULTS
We enrolled 142 patients randomized at a single center to have either the radial artery or saphenous vein grafted to a stenosed branch of the native left circumflex coronary artery. The primary end point was angiographic graft patency 5 years postoperatively. At 5 years, 134 patients were alive and eligible for reangiography (5-year survival, 94.4%). Angiography was performed in 103 patients (77%); 98.3% of radial artery grafts and 86.4% of saphenous vein grafts were patent (P=0.04). Graft narrowing occurred in 10% of patent radial artery grafts and 23% of patent saphenous vein grafts (P=0.01).


CONCLUSIONS
Radial artery aortocoronary bypass grafts to a stenosed branch of the circumflex coronary artery have an excellent patency rate at 5 years. This was significantly better than the patency rate for saphenous vein grafts and comparable to reported patency rates for internal thoracic artery grafts.
Collins
Peter
P
Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
Webb
Carolyn M
CM
Chong
Chee F
CF
Moat
Neil E
NE
D000328:Adult; D000368:Aged; D000792:Angiography; D001807:Blood Vessel Prosthesis / Q000592:standards*; D019917:Blood Vessel Prosthesis Implantation; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D017534:Radial Artery / Q000637:transplantation*; D012501:Saphenous Vein / Q000637:transplantation*; D016896:Treatment Outcome; D014654:Vascular Patency