This Article Free upon publication Full Text Full Text (PDF) CME: Take the course for this article: Circulation: June 3, 2008, Volume 117, Number 22 All Versions of this Article: 117/22/2859    most recent CIRCULATIONAHA.107.736215v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Collins, P. Search for Related Content PubMed PubMed Citation Articles by Collins, P. Related Collections CV surgery: coronary artery disease Angiography Chronic ischemic heart disease Related Article

(Circulation. 2008;117:2859-2864.)
© 2008 American Heart Association, Inc.

Cardiovascular Surgery

Radial Artery Versus Saphenous Vein Patency Randomized Trial

Five-Year Angiographic Follow-Up

Peter Collins, MD, FRCP; Carolyn M. Webb, PhD; Chee F. Chong, MD, FRCS; Neil E. Moat, FRCS, for the Radial Artery Versus Saphenous Vein Patency (RSVP) Trial Investigators

From the Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College London (P.C., C.M.W.), and Departments of Cardiology (P.C., C.M.W.) and Cardiac Surgery (C.F.C., N.E.M.), Royal Brompton and Harefield NHS Trust, London, UK.

Correspondence to Neil Moat, Department of Cardiac Surgery, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK. E-mail n.moat{at}rbht.nhs.uk

Received August 23, 2007; accepted March 7, 2008.

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 (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.

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CLINICAL PERSPECTIVE

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Clinical Summaries
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