Radial artery patency and clinical outcomes: Five-year interim results of a randomized trial

Brian F. Buxton, Jai S. Raman, Permyos Ruengsakulrach, Ian Gordon, Alex Rosalion, Rinaldo Bellomo, Mark Horrigan, David L. Hare, Stephen E. Fremes

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141 Citations (Scopus)

Abstract

Objective: This study was undertaken to compare elective angiographic patency and cardiac event-free survival of the radial artery graft with that of the free right internal thoracic artery or saphenous vein during a 10-year period after primary coronary artery bypass surgery. Methods: This prospective, randomized, single-center trial was conducted on two groups of patients undergoing primary coronary artery bypass surgery. In a younger group (group 1, n = 285, <70 years), the radial artery was compared with the free right internal thoracic artery. In an older group (group 2, n = 153, ≥70 years), the radial artery was compared with the saphenous vein. The trial conduit was grafted to the largest available coronary artery other than the left anterior descending coronary artery. Angiography was scheduled at intervals between 0 and 10 years according to a second random assignment. Patients were followed up at yearly intervals to assess clinical outcomes. Clinical outcomes were analyzed on an intent-to-treat basis during the 10-year follow-up with time-related analyses. This interim study reports angiographic and clinical outcome results during the first 5 years. Results: Graft patency estimates were as follows: 0.95 (95% confidence interval 0.85-0.99) in 39 radial arteries versus 1.0 in 29 right internal thoracic arteries (P = .4) in group 1, and 0.86 (95% confidence interval 0.67-0.99) in 24 radial arteries versus 0,95 (95% confidence interval 0,83-0.99) in 22 saphenous veins (P = .5) in group 2. Cardiac event-free survival estimates were as follows: 0.91 (95% confidence interval 0.76-0.99) for the radial artery versus 0.82 (95% confidence interval 0.63-0.99) for the right internal thoracic artery (P = .7) in group 1, and 0.84 (95% confidence interval 0.64-0.99) for the radial artery versus 0.89 (95% confidence interval 0.72-0.99) for the saphenous vein (P = .9) in group 2. Conclusion: The 5-year interim results do not support the hypothesis that the radial artery has superior patency to or is associated with fewer clinical events than free right internal thoracic artery or saphenous vein grafts.

Original languageEnglish
Pages (from-to)1363-1370
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume125
Issue number6
DOIs
Publication statusPublished - 1 Jun 2003
Externally publishedYes

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