Long-term observational angiographic patency and perfect patency of radial artery compared with saphenous vein or internal mammary artery in coronary bypass surgery

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作   者：

Ren, Justin;  Royse, Colin;  Siderakis, Christopher;  Srivastav, Nilesh;  Royse, Alistair; 

作者机构：

The University of Melbourne Department of Surgery;  Cleveland Clin;  Royal Melbourne Hosp; 

关键词：

multiple arterial grafting;  total arterial revascularization;  target coronary territories;  radial artery;  coronary artery bypass grafting;  internal mammary artery;  angiographic patency; 

期刊名称：

The Journal of Thoracic and Cardiovascular Surgery

i s s n：

0022-5223

年卷期：

2024 年 167 卷 4 期

页   码：

1301-1302

页   码：

摘   要：

Objectives: It is uncertain if the long -term biological behavior of the radial artery as a conduit for coronary bypass surgery has a similar resistance to the development of atherosclerosis as for the internal mammary artery. We aimed to examine longterm angiographic patency and disease-free patency (perfect patency) for internal mammary artery, radial artery, and saphenous vein grafts. Methods: A retrospective, single -center, individual patient cohort study of angiographic observations from patients' latest postoperative angiogram from 1997 to 2020 was performed. Analysis was per anastomosis and assessed for patency and perfect patency. A generalized linear mixed model premised upon logistic regression was used to minimize confounding bias. Results: A total of 983 patients with 3064 grafts were included, with a median follow-up of 8.6 (interquartile range, 4.4-12.6) years after the operation. Multivariable analysis revealed differences for radial (patency, 86.9%; perfect patency, 86.4%) and internal mammary artery (patency, 93.9%; perfect patency, 93.5%) versus saphenous vein graft (patency, 72.8%; perfect patency, 46.2%). There were no differences between the 2 arterial conduits for patency (odds ratio, 1.40; 95% CI, 0.85-2.33; P = .189) and perfect patency (odds ratio, 1.14; 95% CI, 0.711.84; P = .578). If a conduit was patent, then 99.4% of radial artery, 99.6% of internal mammary artery, and 63.5% of saphenous vein graft were reported as perfectly patent. Conclusions: Radial artery and internal mammary artery had similar patency and perfect patency while both were superior to saphenous vein graft.