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document
Comparable patencies of the radial artery and right internal thoracic artery or saphenous vein beyond 5 years : results from the Radial Artery Patency and Clinical Outcomes trial . OBJECTIVE To investigate the optimum conduit for coronary targets other than the left anterior descending artery , we evaluated long-term patencies and clinical outcomes of the radial artery , right internal thoracic artery , and saphenous vein through the Radial Artery Patency and Clinical Outcomes trial . METHODS As part of a 10-year prospective , randomized , single-center trial , patients undergoing primary coronary surgery were allocated to the radial artery ( n = 198 ) or free right internal thoracic artery ( n = 196 ) if aged less than 70 years ( group 1 ) , or radial artery ( n = 113 ) or saphenous vein ( n = 112 ) if aged at least 70 years ( group 2 ) . All patients received a left internal thoracic artery to the left anterior descending , and the randomized conduit was used to graft the second largest target . Protocol-directed angiography has been performed at randomly assigned intervals , weighted toward the end of the study period . Grafts are defined as failed if there was occlusion , string sign , or greater than 80 % stenosis , independently reported by 3 assessors . Analysis is by intention to treat . RESULTS At mean follow up of 5.5 years , protocol angiography has been performed in groups 1 and 2 in 237 and 113 patients , respectively . There are no significant differences within each group in preoperative comorbidity , age , or urgency . Patencies were similar for either of the 2 conduits in each group ( log rank analysis , P = .06 and P = .54 , respectively ) . The differences in estimated 5-year patencies were 6.6 % ( radial minus right internal thoracic artery ) in group 1 and 2.9 % ( radial minus saphenous vein graft ) in group 2 . CONCLUSION At mean 5-year angiography in largely asymptomatic patients , the selection of arterial or venous conduit for the second graft has not significantly affected patency . This finding offers surgeons , for now , enhanced flexibility in planning revascularization .
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Intervention_Educational
radial artery
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Intervention_Educational
internal thoracic artery
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Intervention_Educational
saphenous vein
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Intervention_Surgical
left internal thoracic artery to the left anterior descending
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Intervention_Physical
Protocol-directed angiography
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Outcome_Physical
Patencies
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Outcome_Physical
5-year patencies
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Participant_Condition
primary coronary surgery
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Participant_Sample-size
198
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Participant_Sample-size
196
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Participant_Age
less than 70
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Participant_Sample-size
113
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Participant_Sample-size
112
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Participant_Age
at least 70
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Participant_Sample-size
237
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Participant_Sample-size
113