Radial Artery and Saphenous Vein Patency Five Years After CABG

The Radial Artery Patency Study (RAPS) published on June 25 in the Journal of the American College of Cardiology (JACC) found that radial arteries are associated with reduced rates of functional and complete graft occlusion compared with saphenous vein grafts (SVGs) more than five years after coronary artery bypass surgery (CABG).

As previously reported, complete graft occlusion was reduced in the radial artery compared with study SVG one year after surgery. This study "is the first multicenter clinical trial reporting radial graft patency beyond five years."

The study looked at 510 patients less than 80 years of age, undergoing nonemergent primary isolated CABG with triple-vessel disease in nine Canadian centers. "Target vessels for the radial artery and study SVG were the right and circumflex coronary arteries, which had >70 percent proximal stenosis."

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"Within-patient randomization was performed whereby each patient was randomly allocated to undergo surgery according to one of two strategies; the radial artery was used for the right coronary territory and the study SVG was used for the circumflex region or the radial artery was used for the circumflex territory and the study SVG was used for the right coronary system," note the authors.

Results showed "a total of 269 patients underwent late angiography at a mean of 7.7 +/- 1.5 years after surgery, the frequency of functional graft occlusion was lower in radial arteries compared with SVGs, and the frequency of complete graft occlusion was also significantly lower in radial compared with SVGs."

The authors conclude that "the RAPS study supports the use of the radial artery as a second arterial conduit, or as a third arterial conduit in association with both internal thoracic artery grafts, particularly for patients with high-grade target vessel proximal stenosis." The authors add that, "the benefits of the radial artery compared with a vein graft persists over 7.5 years."

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