Radial Artery Versus Saphenous Vein Patency Randomized Trial

Abstract

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. Methods and 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 (Pϭ0.04). Graft narrowing occurred in 10% of patent radial artery grafts and 23% of patent saphenous vein grafts (Pϭ0.01). 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. (Circulation. 2008;117:2859-2864.)

Rare Bleeding Complication of the Radial Artery Conduit after Coronary Artery Bypass Grafting with Endoscopic Harvesting

“…[1][2][3] The superior patency rate of the radial artery has an advantage over that of the saphenous vein in midterm and long-term results. 2,3) Traditional open radial artery harvesting creates a full forearm longitudinal scar with some neuralgic complications. Recently, ERAH is widely used because it offers superior cosmetic results and avoids neuralgic complications.…”

“…[1][2][3] Endoscopic radial artery harvesting (ERAH) facilitates the use of the radial artery with less morbidity. [4][5][6][7] However, the procedure of ERAH certainly has a learning curve.…”

Coronary artery bypass grafting in diabetic patients: Should we still use the saphenous vein graft? A review of literature in the past 15 years

“…The Radial Artery Versus Saphenous Vein Graft Patency (RSVP) trial was a single-center, prospective, randomized clinical trial designed to compare 5-year patency rates of RA and SV aortocoronary grafts to the circumflex coronary artery [56].…”

“…Several investigators have shown that GEA can be used without increased morbidity, particularly in abdominal complications [65,66], and the late survival rate has been excellent in CABG with GEA plus internal thoracic artery grafts [18,56,67,68].…”

Radial artery and right internal thoracic artery: jousting for the throne of coronary artery bypass grafting

“…This continues to occur despite a large body of evidence demonstrating improvements in clinical outcomes for patients who receive more than one arterial graft during CABG. Several randomized controlled trials (RCTs) suggest better patency rates for the radial artery (RA) versus the saphenous vein (SV) (2)(3)(4). Growing evidence has demonstrated the superiority of the RA and right internal thoracic artery (RITA) in regards to patency when compared to the SV (5).…”