Radial Artery Versus Saphenous Vein Patency Randomized Trial: Five-Year Angiographic Follow-Up
Topic: Cardiovascular Surgery
Clinical Trial: yes

Study Question: What is the long-term efficacy of a saphenous vein graft compared with a radial artery graft in patients undergoing aorto-coronary bypass grafting surgery (CABG)?

Methods: The RSVP trial investigators randomized 142 patients undergoing CABG at a single center to have either the radial artery or saphenous vein grafted to a stenosed branch of the native left circumflex coronary artery. The primary endpoint was angiographic patency at 5 years.

Results: The 5-year survival was 94.4%, with 134 patients being alive. There was no difference in survival between the two arms. Angiography was performed in 103 patients (77%). Among this population, radial artery grafts were more likely to be patent (98.3% vs. 86.4% of saphenous vein grafts, p = 0.04). Graft stenosis developed in 10% of patent radial artery grafts and 23% of patent saphenous vein grafts (p = 0.01). The single case of radial artery graft occlusion occurred in a patient who underwent grafting for mild disease.

Conclusions: Radial artery bypass grafts are associated with an excellent 5-year patency.

Perspective: There has been considerable debate on the relative long-term patency of radial artery bypass grafts compared with saphenous vein grafts. Even though this study is small and was terminated prematurely, it is the best