Abstract 2116: A Randomized Trial of Radial Artery and Saphenous Vein Grafts: 5-Year Patency
Objectives: To compare, in the setting of a randomized trial, the 5-year patency rates of radial artery (RA) and saphenous vein (SV) aorto-coronary bypass grafts to a single coronary territory.
Methods: Between 1998 and 2000, 142 patients were randomly assigned to receive either a RA or a SV graft to a coronary target vessel in the circumflex territory. The target vessel had stenosis >75%. For the first 100 patients, the study was designed to randomize 2:1 in favor of RA grafts and thereafter 2:1 in favor of SV grafts.
Results: Repeat coronary angiography to assess patency of the randomized grafts was performed at (mean±SD) 67±10 months post-surgery. To date 101 of 134 (75%) eligible patients (7 deceased, 1 withdrew) have been recatheterized. Of this group 59 were randomized to RA and 42 to SV. Three (5%) RA grafts were occluded or significantly (>70%) stenosed compared with 9 (21%) SV grafts (p=0.012). Of the deceased patients, 3 had received RA and 4 a SV graft.
Conclusions: At 5-year follow-up there is a clear difference with regard to patency of the RA compared with SV grafts. These results may have important implications for the choice of conduit in coronary artery bypass surgery.