Key result
Radial artery shows no benefit over saphenous vein graft for 4-year major events.
Why the study?
The clinical outcomes comparing radial artery versus saphenous vein as a second conduit in CABG alongside LIMA were not well established.
Does CABG with a radial artery graft compared to a saphenous vein graft as a second conduit improve clinical outcomes in patients with coronary artery disease?
RCT (n=200)
1:1
Yes
Does CABG with a radial artery graft compared to a saphenous vein graft as a second conduit improve clinical outcomes in patients with coronary artery disease?
p-value: p=0.509
In a small randomized trial, using a radial artery versus a saphenous vein graft as a second conduit during CABG showed no difference in 4-year clinical outcomes.
No difference in 4-year outcomes with RA versus SVG as second conduit; leaves open optimal choice in larger trials.
Aims: The aim this study was to see the clinical outcome of coronary artery bypass grafting (CABG) in patients of coronary artery disease and to compare the patients revascularisedwith left internal mammary artery (LIMA) and radial artery (RA) group with LIMA and reverse saphenous venous group(RSVG) group.Methods:Between March 2011 and November 2015, 200 patients underwent isolated CABG and were randomized in 1:1 fashion to receive either LIMA and RA grafts or LIMA and SVGs.All patients were operated in department of cardiac surgery, National Institute of Cardiovascular Disease (NICVD) and Hospital, Dhaka, Bangladesh and Al Helal Specialized Hospital, Mirpur- 10, Dhaka.Written consent was obtained from all patients prior to the procedure. Patients were followed for 4 years since index surgery for the composite of cardiovascular mortality, non-fatal myocardial infarction and need for repeat myocardial revascularization (either surgical or percutaneous). Data were collected either by phone or during visits. The data were entered into an electronic database (Access, Microsoft) and analyzed using the SPSS 16.0 software (SPSS Inc.).Results: This study reports on our series of 200 patients undergoing isolated, primary CABG using LIMA grafting and the SVG in one group, and RA grafting as the second conduit in the second group. Our data indicate that there is no difference in the long-term clinical outcome between the patients in whom RA or SVG is used as a second conduit, beside LIMA.Conclusion: In this small randomized study our data indicate that there is no difference in the 4 year clinical outcomes in relatively young patients between those having a RA or a saphenous vein graft used as a second conduit, beside LIMA, for surgical myocardial revascularization.University Heart Journal Vol. 13, No. 1, January 2017; 21-25
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Alam et al. (2018) conducted an RCT in Coronary artery disease (n=200). Radial artery graft vs. Saphenous vein graft was evaluated on Composite of cardiovascular mortality, non-fatal myocardial infarction, and need for repeat myocardial revascularization (p=0.509). The use of a radial artery compared with a saphenous vein graft as a second conduit alongside the left internal mammary artery resulted in no significant difference in 4-year composite clinical outcomes (p=0.509).
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