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On-line Access: 2011-04-06

Received: 2010-06-24

Revision Accepted: 2010-11-29

Crosschecked: 2011-03-07

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Journal of Zhejiang University SCIENCE B 2011 Vol.12 No.4 P.273-279

10.1631/jzus.B1000241


Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries


Author(s):  Xiang Hu, Qiang Zhao

Affiliation(s):  Department of Cardiac Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China

Corresponding email(s):   zq11607@rjh.com.cn

Key Words:  Coronary artery bypass grafting (CABG), Arterial grafts, Meta-analysis


Xiang Hu, Qiang Zhao. Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries[J]. Journal of Zhejiang University Science B, 2011, 12(4): 273-279.

@article{title="Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries",
author="Xiang Hu, Qiang Zhao",
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%T Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries
%A Xiang Hu
%A Qiang Zhao
%J Journal of Zhejiang University SCIENCE B
%V 12
%N 4
%P 273-279
%@ 1673-1581
%D 2011
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1000241

TY - JOUR
T1 - Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries
A1 - Xiang Hu
A1 - Qiang Zhao
J0 - Journal of Zhejiang University Science B
VL - 12
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SP - 273
EP - 279
%@ 1673-1581
Y1 - 2011
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1000241


Abstract: 
Coronary artery bypass grafting surgery is increasingly being carried out on patients with multi-vessel coronary artery disease, but the best grafting candidate for non-left anterior descending coronary arteries is unclear. This research sought to systematically compare the efficacies and safeties of coronary bypass with radial artery and other available grafts. A systematic literature retrieval was performed for all clinical trials comparing the outcomes of coronary artery bypass surgery with radial artery and other grafts in PubMed, EMBASE, and the Cochrane Library. Seven eligible clinical studies, comparing radial artery and great saphenous vein grafts, were found between 1966 and 2010: one prospective non-randomized and six prospective randomized trials. The pooling analysis obtained a relative risk of 0.507 (P<0.05) of graft occlusion in radial arteries compared with great saphenous veins. There was a significantly lower infection rate in arms (i.e., harvest sites for radial arteries) relative to legs (harvest sites for veins), with a pooled relative risk of 0.140 (P<0.05). From the reports on mortality after follow-up ranging from one year to six years, there was no significant difference in mortality between the two graft types (P=0.927). In addition, four cohort controlled trials for radial and right internal thoracic artery grafts were included. The radial graft was associated with less cardiac related events relative to the right internal thoracic artery graft (P=0.014), but with comparable mortality and comparable rates of repeat percutaneous transluminal coronary angioplasty. Subjects with radial arteries seemed to have a lower occlusion rate and a lower graft harvest site infection rate than those with great saphenous veins. Moreover there were fewer cardiac related events with radial arteries relative to the right internal thoracic artery grafts. More studies are needed to confirm these findings concerning the favorable outcomes of coronary artery bypass grafting with radial arteries on long-term patency and mortality.

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Reference

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