Published Online
on May 27, 2008

A more recent version of this article appeared on June 3, 2008

This Article 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 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

Submitted on August 23, 2007
Accepted on March 7, 2008

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.

^* To whom correspondence should be addressed. E-mail: n.moat{at}rbht.nhs.uk.

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.

Key words: arteries • coronary disease • follow-up studies • revascularization • surgery

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Clinical Summaries
Circulation 2008 117: 2841-2843. [Extract] [Full Text]

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