Original articleAdult cardiacAngiographic Outcome of Coronary Artery Bypass Grafts: The Radial Artery Database International Alliance
Section snippets
Data Set
Details of the Radial Artery Database International Alliance (RADIAL) project have previously been published.2 The list of the RADIAL investigators is provided in Supplemental Table 1. Briefly, RADIAL is a patient-level database pooling 6 RCTs comparing the long-term outcomes of the radial artery (RAD) and other conduits at a mean follow up of 2 or more years. The 6 RCTs included are the Radial Artery Patency and Clinical Outcomes (RAPCO, groups 1 and 2), the Radial Artery Patency Study (RAPS),
Results
The angiographic analysis included 1091 patients and 2281 grafts, representing 71.8% of the total number of the patients enrolled in the 5 RCTs (1091 of 1519). The mean age was 64.9 ± 9.5 years, there were 825 men (75.6%), 329 patients (30.2%) were diabetic, 349 (32.0%) had previous MI, and 170 (15.6%) had an LVEF of less than 0.50. The mean number of grafts per patient was 3.4 ± 0.7. Demographics of the study population are reported in Table 1.
There were 921 left internal mammary arteries
Comment
With 1091 patients and 2281 grafts at a mean follow-up of 65 ± 29 months and a repeat angiography rate of almost 72%, RADIAL is one of the largest and the most complete coronary graft angiographic databases. The results of our analysis show that the failure of the LIMA-to-LAD bypass is a very uncommon event, so that even with a large patient sample, it was not possible to define independent risk factors for it. For the non-LAD distribution, the nonuse of the RAD, age 75 years or older, female
References (15)
- et al.
Relation of early saphenous vein graft failure to outcomes following coronary artery bypass surgery
Am J Cardiol
(2005) - et al.
Radial artery and saphenous vein patency more than 5 years after coronary artery bypass surgery: results from RAPS (Radial Artery Patency Study)
J Am Coll Cardiol
(2012) - et al.
Arterial revascularization in primary coronary artery bypass grafting: direct comparison of 4 strategies—results of the Stand-in-Y Mammary Study
J Thorac Cardiovasc Surg
(2009) - et al.
Coronary bypass graft fate and patient outcome: angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,388 patients during 25 years
J Am Coll Cardiol
(1996) - et al.
Long-term clinical outcome and graft patency of radial artery and saphenous vein grafts in multiple arterial revascularization
J Thorac Cardiovasc Surg
(2019) - et al.
Radial artery as a coronary artery bypass conduit: 20-year results
J Am Coll Cardiol
(2016) - et al.
21-year survival of left internal mammary artery-radial artery-Y graft
J Am Coll Cardiol
(2018)
Cited by (8)
Conduit selection and early graft failure in coronary artery bypass surgery: A post hoc analysis of the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) coronary artery bypass grafting study
2023, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :The RIMA is expected to play a key role in facilitating multiple or total arterial grafting for improving outcomes for patients undergoing CABG surgery. However, the relative rate of RIMA graft failure is currently under scrutiny, as trial and meta-analysis have reported greater-than-expected rates of failure (eg, COMPASS CABG11 and Radial Artery Database International Alliance [RADIAL]7). In a 2020 meta-analysis that provided Kaplan–Meier curves, long-term occlusion rates were greatest in RIMA beyond 5 years after surgery.7
Commentary: Harvesting the Internal Thoracic Artery: Let the skeletons Out of the Closet!
2021, Seminars in Thoracic and Cardiovascular SurgeryUnanswered questions on coronary artery graft patency and clinical outcomes
2023, Current Opinion in CardiologyIs the COMPASS pointing towards clinical equipoise for the right internal mammary artery?
2023, Indian Journal of Thoracic and Cardiovascular SurgeryApplication of radial artery in total arterial coronary revascularization in elderly patients
2023, Chinese Critical Care Medicine
A complete list of investigators of the RADIAL (Radial Artery Database International ALliance) project is provided in the Supplemental Material.
- ∗
Drs Gaudino and Benedetto contributed equally to this work.