Comparative Study between Radial Artery Versus Saphenous Vein Grafts Patency After 5 Years

Abstract

Background:Graft patency is a fundamental predictor of long-term survival
aftercoronary artery bypass surgery. Left and right internal thoracic artery (arterial) graft
patency has been shown to be superior to that of saphenous vein grafts. More recently, the
radial artery has been used as an aortocoronary graft, but little is known about the midterm
and long-term patency of this conduit. The ultimate goal of this operation is to achieve
complete revascularization of the patient with conduits that will remain patent for the
duration of the patient’s lifetime. The excellent patency rates achieved with the pedicled left
internal mammary artery are well described. Over the past decade, there has been
considerable interest in whether the left internal mammary radial artery may provide results
comparable to the arterial conduit. However, other studies have described that mild proximal
stenosis of target vessels correlated with graft occlusion when an RA graft was used. Thus,
we compared the short- and long-term results of patients who received an RA graft to the
OM with those of patients who received an SVG.Methods:Following approval by the ethics
and research committee of Kasr el Ainy faculty of Medicine Cairo University, and obtaining
an informed consent, a prospective randomized clinical study was conducted on FIFTY who
were operated upon with CABG.Requiring in addition to LIMA to LAD, revascularization of
an obtuse marginal. These patients included 25 patients who received radial artery as the
conduit. The selected patients for this study were evaluated postoperatively by MSCT
angiography to comparative study between radial artery versus saphenous vein grafts patency
after 5 years.Results: In our study according to graft patency by MSCT postoperative after 5
years of both groups showed statistically significant difference in group A which is p value
0.047 in group A 22 patients (88.0%) with radial to OM graft were patent while 3 patients
(12.0%) with radial to OM were occluded. But in group B 16 patients (64.0%) with
saphenous to OM graft were patent while 9 patients (36%) with saphenous to OM were
occluded. Conclusion:In the long-term study, there was significant difference between total
arterial revascularization and conventional CABG.