The radial artery versus the saphenous vein graft in contemporary CABG: a case-matched study

Cohen, Gideon; Tamariz, Miguel; Sever, Jeri; Liaghati, Negin; Guru, Veena; Christakis, George T.; Bhatnagar, Gopal; Cutrara, Charles; Abouzahr, Labib; Goldman, Bernard S.; Fremes, Stephen E.

doi:10.1016/s0003-4975(00)02285-2

Cited by 61 publications

(44 citation statements)

References 20 publications

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“…Rates of reintervention are very low after CABG using the RA. Our findings and numerous other reports 8,9,[12][13][14]18,19 clearly support the expanded use of RA grafting during CABG.…”

Section: Discussionsupporting

confidence: 88%

Coronary Artery Bypass Grafting Using the Radial Artery

et al. 2012

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Background-Radial artery (RA) grafts are an attractive second arterial conduit after the left internal thoracic artery (LITA) for coronary artery bypass graft (CABG) surgery. However, long-term outcomes and the need for subsequent reintervention have not been defined. Methods and Results-We performed a retrospective cohort study of our single institution's 16-year experience with 1851 consecutive patients (average age, 58 years; 82% men, 36% diabetic) undergoing primary, isolated CABG with the LITA, RA, and saphenous vein as needed. Average grafts per patient were 3.8, with 2.4 arterial grafts per patient. Survival was determined using the Social Security Death Index. Grafts were nonpatent if they had a Ͼ50% stenosis, a string sign, or were occluded. Five patients (0.3%) died in hospital and 0.8% had a myocardial infarction, 1.1% a stroke, and 0.6% renal failure. Kaplan-Meier-estimated 1-, 5-, 10-, and 15-year survival was 99%, 96%, 89%, and 75%, respectively. Of the cohort, 278 symptomatic patients underwent cardiac catheterization at our institution an average of 5.0Ϯ3.8 years (range, 0.1-12 years) after CABG. Overall RA (nϭ420 grafts) patency was 82% and SV (nϭ364 grafts) patency, 47% (PϽ0.0001). LITA (nϭ287 grafts including 9 sequential grafts) patency was 85% and right internal thoracic artery (nϭ15 grafts) patency was 80% (Pϭ0.6). RA patency was not different from LITA patency (Pϭ0.3). Overall freedom from catheterization, percutaneous coronary intervention, and CABG was 85%, 97%, and 99%, respectively. Conclusions-RA grafting is a highly effective revascularization strategy providing excellent short and long-term outcomes with very low rates of reintervention. RA patency is similar to LITA patency and is much better than SV patency. RA grafting should be more widely utilized in patients undergoing CABG. (Circulation. 2012;126[suppl 1]:S170 -S175.)

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“…Rates of reintervention are very low after CABG using the RA. Our findings and numerous other reports 8,9,[12][13][14]18,19 clearly support the expanded use of RA grafting during CABG.…”

Section: Discussionsupporting

confidence: 88%

Coronary Artery Bypass Grafting Using the Radial Artery

et al. 2012

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“…26 When compared with other vascular conduits, the RA provides additional benefits. According to observational studies, relative to SV grafts, RAs can be harvested without interfering with ambulation and their use has been shown to be protective against both early and late mortality and morbidity, 28 resulting in enhanced late survival. 29 Also, unlike SV grafts, RA grafts are adapted to higher arterial pressures and have a homogeneous caliber free from internal valves, characteristics possibly contributing to the RA's superior results.…”

Section: Potential Advantages Of Radial Artery Usementioning

confidence: 99%

Should Radial Arteries Be Used Routinely for Coronary Artery Bypass Grafting?

et al. 2004

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“…10 Cohen et al reported that cumulative angiographic patency rates of approximately 97.5% could be expected early postoperatively (<3 months), with 93% at 1 year. 11 In contrast, it was reported that up to 15% of SV grafts are occluded within the first postoperative year, 12 and at 10 years postoperatively only 50-60% of SV are patent. 13, 14 As a consequence of clinical reviews examining use of these grafts, it has been believed that RA grafts are safe to use and have a patency rate that is superior to that of SV grafts, despite the absence of long-term outcome data.…”

Section: Discussionmentioning

confidence: 96%

Long-Term Patency Rate for Radial Artery vs. Saphenous Vein Grafts Using Same-Patient Materials

Hata

Yoshitake

Wakui

et al. 2011

Circ J

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Background:The aim of the present study was to assess the long-term graft patency rate of the radial artery (RA), in comparison to the saphenous vein (SV) in patients harvested for both vessels. Methods and Results:RA and SV were concomitantly used for coronary artery bypass grafting in 318 patients in an 8-year period from January 2002 to March 2010. During follow-up, graft patency was assessed on angiography or multi-slice computed tomography in 192 of these patients. Cumulative graft patency rates were compared between RA and SV. Independent predictors for graft failure were examined for both vessels. Cumulative graft patency rates at 8 years were 74.3% in RA and 64.7% in SV, respectively. There was no significant difference between these types of grafts. Independent predictors of late RA graft failure were native coronary stenosis <75% and peripheral vascular disease (PVD). Independent predictors of late SV graft failure were use of only one anti-platelet agent and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio >2.5. Cardiovascular event-free and actuarial survival rates at 8 years in this series were 81.2% and 89.7%, respectively. Conclusions:Cumulative graft patency rates between RA and SV were similar at 8 years. RA performed more poorly in patients with target vessel stenosis <75% and in those complicated by PVD. Aggressive anti-platelet therapy and strict lipid control may be important in maintaining long-term patency of SV. (Circ J 2011; 75: 1373 -1377

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The radial artery versus the saphenous vein graft in contemporary CABG: a case-matched study

Cited by 61 publications

References 20 publications

Coronary Artery Bypass Grafting Using the Radial Artery

Coronary Artery Bypass Grafting Using the Radial Artery

Should Radial Arteries Be Used Routinely for Coronary Artery Bypass Grafting?

Long-Term Patency Rate for Radial Artery vs. Saphenous Vein Grafts Using Same-Patient Materials

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