title: A randomized comparison of the Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial: One-year angiographic results and mid-term clinical outcomes.
abstract: OBJECTIVE
  The Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft (SAVE RITA) trial was designed to evaluate the noninferiority of the saphenous vein (SV) compared with the right internal thoracic artery ([R]ITA) used as a Y-composite graft.
  
  
  METHODS
  A total of 224 patients who had undergone off-pump revascularization for multivessel coronary artery disease using the SV or RITA as a Y-composite graft based on the in situ left ITA were assigned randomly to the SV Y-composite graft (SV group, n = 112) or free RITA Y-composite graft (RITA group, n = 112). The primary endpoint was the 1-year angiographic patency rate of the second limb conduits (SV or RITA). Postoperative 1-year coronary angiograms were performed in 215 patients (SV group, 108; RITA group, 107).
  
  
  RESULTS
  The overall graft patency rate was 97.4% (745 of 765) at 1 year (97.9% in the SV group vs 96.9% in the RITA group, P = .362). The primary endpoint of the study, the 1-year patency rate of the SV composite grafts, was 97.1% (238 of 245) and was noninferior to that of the RITA composite grafts (97.1% [198 of 204]) with a 95% lower confidence limit of -2.6% (P < .001 for noninferiority). The graft qualities, evaluated using the FitzGibbon patency grades, were also similar between the 2 groups (P = .948). No statistically significant differences were found in the overall survival rates between the 2 groups at 1 and 4 years (P = .998). Also, no statistically significant differences were found between the 2 groups in the freedom from major adverse cardiac and cerebrovascular event rates at 1 and 4 years (P = .597).
  
  
  CONCLUSIONS
  The SV composite grafts were noninferior to the RITA composite grafts in terms of the 1-year angiographic patency rates.
authors: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea. Electronic address: kimkb@snu.ac.kr.
authors: Ki-Bong
authors: KB
authors: Kim
authors: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
authors: Ho Young
authors: HY
authors: Hwang
authors: Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea.
authors: Seokyung
authors: S
authors: Hahn
authors: Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Jun Sung
authors: JS
authors: Kim
authors: Department of Thoracic and Cardiovascular Surgery, Seoul National University Boramae Hospital, Seoul, Korea.
authors: Se Jin
authors: SJ
authors: Oh
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D056910:Republic of Korea; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency