Document Detail


Long-term patency rate for radial artery vs. saphenous vein grafts using same-patient materials.
MedLine Citation:
PMID:  21467657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of the present study was to assess the long-term graft patency rate of the radial artery (RA), in comparison to the saphenous vein (SV) in patients harvested for both vessels.
METHODS AND RESULTS: RA and SV were concomitantly used for coronary artery bypass grafting in 318 patients in an 8-year period from January 2002 to March 2010. During follow-up, graft patency was assessed on angiography or multi-slice computed tomography in 192 of these patients. Cumulative graft patency rates were compared between RA and SV. Independent predictors for graft failure were examined for both vessels. Cumulative graft patency rates at 8 years were 74.3% in RA and 64.7% in SV, respectively. There was no significant difference between these types of grafts. Independent predictors of late RA graft failure were native coronary stenosis <75% and peripheral vascular disease (PVD). Independent predictors of late SV graft failure were use of only one anti-platelet agent and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio >2.5. Cardiovascular event-free and actuarial survival rates at 8 years in this series were 81.2% and 89.7%, respectively.
CONCLUSIONS: Cumulative graft patency rates between RA and SV were similar at 8 years. RA performed more poorly in patients with target vessel stenosis <75% and in those complicated by PVD. Aggressive anti-platelet therapy and strict lipid control may be important in maintaining long-term patency of SV.
Authors:
Mitsumasa Hata; Isamu Yoshitake; Shinji Wakui; Satoshi Unosawa; Haruka Kimura; Hiroaki Hata; Motomi Shiono
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-03-31
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-26     Completed Date:  2011-09-16     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1373-7     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan. mihata@med.nihon-u.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Coronary Angiography / methods
Coronary Artery Bypass / adverse effects*
Coronary Stenosis / complications,  radiography,  surgery*
Female
Graft Occlusion, Vascular / etiology*,  physiopathology,  radiography
Humans
Japan
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Peripheral Vascular Diseases / complications
Radial Artery / physiopathology,  radiography,  transplantation*
Risk Assessment
Risk Factors
Saphenous Vein / physiopathology,  radiography,  transplantation*
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Vascular Patency*

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