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editorial
. 2021 Sep 24;10:114–119. doi: 10.1016/j.xjtc.2021.09.039

Table 1.

Summary of the main studies comparing radial artery (RA) with saphenous vein (SV) grafts in coronary artery bypass grafting

Study Study period No. of patients Follow-up (y) Main findings
Gaudino, 20217 1993-2014 3396 5
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    The RA ranked as the best conduit (rank score for RA 0.87 vs 0.85 for no-touch SV, 0.23 for RITA, 0.29 for GEA, and 0.25 for the conventionally harvested SV).

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    Compared with the conventionally harvested SV, only RA (IRR, 0.54; 95% CI, 0.35-0.82) and no-touch SV (IRR, 0.55; 95% CI, 0.39-0.78) were associated with significantly lower rate of graft occlusion, whereas RITA (IRR, 1.02; 95% CI, 0.63-1.65) and GEA (IRR, 0.98; 95% CI, 0.57-1.68) were not.
Gaudino, 20198 1993-2012 20,931 7
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    Long-term mortality was 24.5% in the RA group vs 34.2% in the SV group (IRR, 0.74; 95% CI,: 0.63-0.87). At meta-regression, RA survival benefit was independent of age, sex, diabetes status, and ventricular function.
Gaudino, 20189 1996-2009 1036 5
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    Compared with the SV group, the incidence of adverse cardiac events was significantly lower in the RA group (HR, 0.67; 95% CI, 0.49-0.90).

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    Risk of occlusion (HR, 0.44; 95% CI, 0.28-0.70), incidence of myocardial infarction (HR, 0.72; 95% CI, 0.53-0.99), and repeat revascularization (HR, 0.50; 95% CI, 0.40-0.63) were also lower in the RA group.
Gaudino,
202010 		1997-2009 1036 10
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    RA was associated with a significantly lower incidence of death, myocardial infarction, or repeat revascularization when compared with SV (HR, 0.73; 95% CI, 0.61-0.88).

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    RA was also associated with a significantly lower incidence of death or myocardial infarction (HR, 0.77; 95% CI, 0.63-0.94) and with a higher survival rate (HR, 0.73; 95% CI, 0.57-0.93) when compared with SV.

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    The incidence of repeat revascularization was 63 events in the RA group and 86 events in the SV group (HR, 0.62; 95% CI, 0.45-0.86).
Buxton, 202011 1996-2005 416 10
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    In the RA vs SV comparison, the 10-y patency was 85% for the RA and 71% for the SV (HR, 0.40; 95% CI, 0.15-1.00). The 10-y survival was 72.6% in the RA group and 65.2% in the SV group (HR, 0.76; 95% CI, 0.47-1.22).

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    In the RA vs RITA comparison, 10-y patency was 89% for RA and 80% for free RITA (HR, 0.45; 95% CI, 0.23-0.88). The 10-y survival was 90.9% in the RA group and 83.7% in the RITA group (HR, 0.53; 95% CI, 0.30-0.95).

RITA, Right internal thoracic artery; GEA, gastroepiploic artery; IRR, incidence rate ratio; CI, confidence interval; HR, hazard ratio.