Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10415
Title: Which arterial conduit? Radial artery versus free right internal thoracic artery: six-year clinical results of a randomized controlled trial.
Authors: Hayward, Philip A R;Hare, David L;Gordon, Ian R;Matalanis, George;Buxton, Brian F
Affiliation: Department of Cardiac Surgery, Austin Hospital, Heidelberg, Melbourne, Australia.
Issue Date: 1-Aug-2007
Citation: The Annals of Thoracic Surgery; 84(2): 493-7; discussion 497
Abstract: To investigate the optimum revascularization conduit for coronary territories other than that of the left anterior descending artery, long-term clinical outcomes after use of a radial artery or right internal thoracic artery were evaluated as part of the Radial Artery Patency and Clinical Outcomes (RAPCO) study.As part of a 10-year prospective randomized single-center trial, patients aged less than 70 years undergoing primary coronary surgery were randomly allocated to the use of the radial artery (n = 198) or free right internal thoracic artery (n = 196) for grafting the largest target other than the left anterior descending artery. Annual follow-up documented death, myocardial infarction, or revascularization as primary endpoints. Analysis was on an intention-to-treat basis.There were no significant differences in the preoperative status of the two groups including age, sex, diabetes mellitus, hypertension, and urgency of surgery. One hundred eighty-six of 198 patients in the radial artery group and 179 of 196 patients in the right internal thoracic artery group received the intended conduit. Mean number of grafts was 3.1 +/- 0.8 and 3.2 +/- 0.9 in the radial artery and the right internal thoracic artery groups, respectively. During surveillance of as long as 10.4 years (mean, 6.0), absolute survival and event-free survival were equivalent between groups, with 13 versus 18 deaths and 24 versus 37 events (death, myocardial infarction, or revascularization) in the radial artery and the right internal thoracic artery groups, respectively (log rank: p = 0.36 for survival, p = 0.08 for event-free survival).These two arterial conduits may yield equivalent clinical outcomes at 5 or more years. That finding will be compared with mean 5-year angiographic patency when available. For now, equivalent clinical results offer surgeons flexibility in planning revascularization.
Internal ID Number: 17643621
URI: http://ahro.austin.org.au/austinjspui/handle/1/10415
DOI: 10.1016/j.athoracsur.2007.03.053
URL: http://www.ncbi.nlm.nih.gov/pubmed/17643621
Type: Journal Article
Subjects: Adult
Aged
Anastomosis, Roux-en-Y.methods
Cardiac Surgical Procedures.methods.mortality
Coronary Angiography
Female
Follow-Up Studies
Humans
Male
Mammary Arteries.surgery
Middle Aged
Myocardial Infarction.epidemiology
Myocardial Revascularization
Patient Selection
Prospective Studies
Radial Artery.surgery
Retrospective Studies
Saphenous Vein.surgery
Survival Analysis
Vascular Patency
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.