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Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery
The authors performed a patient-level meta-analysis of six randomized trials comparing left internal mammary artery (LIMA) + saphenous vein graft (SVG) versus LIMA + radial artery graft. In a total of more than 1000 patients and at a follow-up of 60 months, the incidence of adverse cardiac events (death, myocardial infarction, or repeat revascularization) was significantly lower in patients with a radial artery graft as compared with those in the SVG group (hazard ratio, 0.67; 95% confidence interval, 0.49 - 0.90; p = 0.01). Moreover, the patency rate at 50 months of angiographic follow-up was higher in the LIMA + radial artery group. These results emphasize the importance of using more arterial grafts.