The patency of radial artery grafts is not superior to vein grafts (Shelley Wood, 2010).
A new randomized study that compared the patency of arterial grafts (of the radial artery) and vein grafts in coronary artery bypass surgery operations did not prove any differences in the patency over a year. They are the results of the study CSP-474 during a recent conference of the American College of Cardiology in 2010.
The results of the study may surprise some surgeons, who tend to believe that the radial artery could function more as the left internal thoracic artery, which has been proven to be superior to the great saphenous vein in coronary artery bypass surgery (CABG). Indeed, according to the statistical data that have been presented, in more than 163,000 coronary artery bypass operations that have been performed in 2008, radial artery grafts have been used. The study CSP-474, has been conducted in 11 centers between 2003 and 2008, and was planned to show an approximate difference of 10% in the patency between these two types of grafts, with the radial artery graft being superior. Instead, the 1-year patency, as it has been evaluated by angiography, was identical for both types of grafts that have been used in the treatment of the patients.
An analysis that was based on the position of the graft did not show any differences due to the type of graft that has been used. By the way, it is more possible that radial artery grafts present early signs of disease compared to saphenous vein grafts, with 8% of radial artery grafts showing the “string sign” compared to only 1% of the great saphenous vein grafts. A sub-analysis, through the research of the low number of patients who underwent beating heart (off pump) coronary artery bypass surgery has shown that the patency was not different in the radial artery grafts that have been implanted with or without an extracorporeal circulation pump. On the contrary, the patency rate was lower in vein grafts that have been implanted in beating heart coronary artery bypass operations. And, in another interesting result, the endoscopic collection - which had been previously associated with the deterioration of patency – was associated with the deterioration of patency in saphenous vein grafts but not in radial artery grafts.
“To conclude, we have not observed any differences between the radial artery grafts and the saphenous vein grafts within a year”. “We realized that heart surgery is a treatment that is used for long-term results, and thus we can examine long-term patency.”