Radial artery versus saphenous vein graft patency: Meta-analysis of randomized controlled trials

Abstract

The excellent patency rate achieved with the internal thoracic artery in coronary artery bypass grafting (CABG) prompted cardiac surgeons to explore other arteries as second conduits instead of the saphenous vein graft (SVG). Initially described in 1973 by Carpentier and colleagues, the radial artery (RA) was soon abandoned as a bypass graft because reports documented dismal early angiographic outcomes. Because of improvements in graft-harvesting techniques and the use of postoperative calcium-channel blocker therapy to prevent early vasospasm, the RA is newly popular as a second conduit in association with the left internal thoracic artery. However, concerns about the high incidence of RA graft failure caused by a compromised flow state continue to be raised. Thus ongoing debate remains regarding the superiority of the RA as an aortocoronary conduit over the SVG, which continues to be widely used as a second conduit. Therefore, we conducted a meta-analysis on available randomized controlled trials (RCTs) to evaluate whether the RA is associated with a better patency rate when compared with the SVG as a second conduit in CABG.