Original Article
A Randomized Comparison of Radial-Artery and Saphenous-Vein Coronary Bypass Grafts
N Engl J Med 2004; 351:2302-2309November 25, 2004
- Abstract
Background
In the past decade, the radial artery has frequently been used for coronary bypass surgery despite concern regarding the possibility of graft spasm. Graft patency is a key predictor of long-term survival. We therefore sought to determine the relative patency rate of radial-artery and saphenous-vein grafts in a randomized trial in which we controlled for bias in the selection of patients and vessels.
Methods
We enrolled 561 patients at 13 centers. The left internal thoracic artery was used to bypass the anterior circulation. The radial-artery graft was randomly assigned to bypass the major vessel in either the inferior (right coronary) territory or the lateral (circumflex) territory, with the saphenous-vein graft used for the opposing territory (control). The primary end point was graft occlusion, determined by angiography 8 to 12 months postoperatively.
Results
Angiography was performed at one year in 440 patients: 8.2 percent of radial-artery grafts and 13.6 percent of saphenous-vein grafts were completely occluded (P=0.009). Diffuse narrowing of the graft (the angiographic “string sign”) was present in 7.0 percent of radial-artery grafts and only 0.9 percent of saphenous-vein grafts (P=0.001). The absence of severe native-vessel stenosis was associated with an increased risk of occlusion of the radial-artery graft and diffuse narrowing of the graft. Harvesting of the radial artery was well tolerated.
Conclusions
Radial-artery grafts are associated with a lower rate of graft occlusion at one year than are saphenous-vein grafts. Because the patency of radial-artery grafts depends on the severity of native-vessel stenosis, such grafts should preferentially be used for target vessels with high-grade lesions.
Media in This Article
Table 1
Clinical Characteristics of All Patients and Those Who Underwent Follow-up Angiography.Table 2
Operative Data on All Patients and Those Who Underwent Postoperative Angiography.Article Activity
- Article
The internal thoracic artery provides better long-term patency than does the saphenous vein as a conduit for coronary bypass, prompting cardiac surgeons to explore other arterial conduits. The radial artery was first used by Carpentier in 1971,1 because of a number of potential advantages, including ease of harvesting, a low propensity for wound infection, a larger diameter than other arterial grafts, and a thick, muscular wall that facilitates the construction of an anastomosis. However, early experience suggested that radial-artery grafts were prone to spasm and functional occlusion, and their use was abandoned for many years.2,3 The advent of drug therapy to prevent graft spasm and the adoption of newer harvesting techniques have revitalized interest in the radial artery as an additional arterial conduit,4 although an observational study has raised questions regarding its long-term patency.5
To evaluate the potential role of the radial artery as a bypass conduit, we conducted a randomized trial to determine whether the patency rate of radial-artery grafts at 8 to 12 months exceeds that of saphenous-vein grafts. We used a study design that controlled for bias in the selection of patients and vessels.
Methods
Study Design
The study design has been described in detail elsewhere.6 In brief, each patient received both a radial-artery graft and a saphenous-vein graft, but these were randomly allocated to two different coronary territories. Although the random assignment of grafts rather than patients precludes meaningful clinical comparisons, it serves to control for bias in patient and vessel selection and permits an unbiased comparison of the two types of grafts in terms of patency, the primary determinant of survival. Thus, the primary study objective was to compare the angiographic patency of radial-artery grafts with that of saphenous-vein grafts 8 to 12 months after surgery.
Patient Population
Patients less than 80 years of age who were undergoing primary, isolated coronary bypass surgery on a nonemergency basis were eligible for the study if they had graftable triple-vessel disease and an estimated left ventricular ejection fraction greater than 35 percent. The target coronary vessels were the left circumflex and right coronary arteries, which had to be at least 1.5 mm in diameter, with proximal lesions causing narrowing of at least 70 percent of the diameter. Exclusion criteria included nonpalpable ulnar arteries or a positive Allen's test; an abnormal Doppler study or ultrasonographic study of the arms; or a history of vasculitis or Raynaud's syndrome, bilateral varicose veins or vein stripping, or conditions that affected the safety of follow-up angiography, as described elsewhere.6 The study was approved by the research ethics committee at each participating center. All patients provided written informed consent.
Randomization and Study Procedures
Randomization was carried out in the operating room with the use of sealed envelopes, with stratification according to site and a randomly determined block size of four to six. Patients were randomly assigned to undergo surgery according to one of two strategies: radial-artery grafting to the circumflex territory and saphenous-vein grafting to the right coronary artery or radial-artery grafting to the right coronary artery and saphenous-vein grafting to the circumflex territory. With randomization performed within rather than between patients, each patient served as his or her own control for patient-level factors.
The internal thoracic artery was used to bypass the distribution of the left anterior descending coronary artery. Additional grafts were constructed as necessary. Single rather than sequential grafts were constructed; full details of the surgical technique have been previously reported.7
Postoperative Management and Follow-up
Patients received 325 mg of aspirin within six hours postoperatively and daily thereafter. Intravenous nitroglycerin was administered for 24 hours postoperatively. Treatment with vasoconstrictor agents was avoided whenever possible. Oral calcium-channel blockade was initiated on the first postoperative day and continued for six months. Study electrocardiograms were obtained preoperatively and on days 1 and 5 postoperatively. Patients were interviewed by telephone at one month, three months, six months, and yearly thereafter. If the patient had been hospitalized between interviews, in-patient records were obtained. All patients were questioned about the function of their hands and arms with the use of a modification of the Disabilities of the Arm, Shoulder and Hand questionnaire.8
Follow-up Angiography
Follow-up angiography was performed 8 to 12 months after surgery. Nitroglycerin was injected into each graft before filming. At least two orthogonal views each of the radial-artery graft and the control saphenous-vein graft were obtained, with continued exposure as required to visualize distal runoff and the size of the target bed.
End Points
The primary end point was the proportion of radial-artery and saphenous-vein grafts that were completely occluded at follow-up angiography. Complete occlusion was defined as the absence of visible opacification of the target coronary vessel (i.e., Thrombolysis in Myocardial Infarction [TIMI] flow grade 0).9 Secondary angiographic end points included perfect graft patency (TIMI flow grade 3), angiographic stenosis of any degree (assessed visually), and the presence of diffuse narrowing of the graft to less than 1 mm in diameter but with a TIMI flow grade of at least 1 (the angiographic “string sign”).
Follow-up angiograms were centrally reviewed by a committee of four experienced cardiologists. Each angiogram was independently adjudicated in a blinded fashion by two committee members, with a third review in the case of disagreement.
The following clinical events were recorded: death from any cause, perioperative myocardial infarction (occurring between 0 and 30 days), late myocardial infarction (occurring between 31 days and 1 year), additional cardiac surgery, and coronary angioplasty. Hand claudication and thenar paresthesia, complications potentially related to harvesting of the radial artery, were reported according to the diagnoses specified by a consultant neurologist. Because all patients received a study radial-artery graft, clinical events are reported for the entire study population only.
Statistical Analysis
Data from case-record forms were double entered to minimize errors. The primary comparison between the proportion of radial-artery grafts and that of saphenous-vein grafts that were occluded was performed on an intention-to-treat basis with the use of McNemar's test for paired proportional data. A P value of less than 0.048 was considered to indicate statistical significance, so as to achieve an overall level of 0.05 adjusted for a single interim analysis.
We calculated that the enrollment of 464 patients would provide the study with 80 percent power to detect a relative reduction of 40 percent in the rate of graft occlusion, from an estimated 12 percent with saphenous-vein grafting to 7.2 percent with radial-artery grafting, assuming a 20 percent within-patient correlation for graft occlusion, a two-tailed test, and an alpha value of 0.05. The sample size was increased to 561 patients to allow for the lack of follow-up angiography in approximately 20 percent of patients.
Results
Patients
Thirteen centers (12 in Canada and 1 in New Zealand) enrolled 561 patients between November 1996 and January 2001. Table 1Table 1
Clinical Characteristics of All Patients and Those Who Underwent Follow-up Angiography. lists the baseline characteristics of the total study population and the 440 patients who underwent postoperative angiography. Patients who underwent follow-up angiography were generally representative of the entire study population, although fewer were over the age of 70 years (P=0.01). The severity of stenosis in native coronary vessels was similar in the target vessels for radial-artery grafts and saphenous-vein grafts, indicating that the randomization was balanced.Operative Data
Operative data are presented in Table 2Table 2
Operative Data on All Patients and Those Who Underwent Postoperative Angiography.. As described elsewhere,7 a dilute solution of verapamil and papaverine was delivered into 92.3 percent of study radial-artery grafts to prevent spasm. Proximal anastomosis was achieved to the aorta in 98.4 percent of radial-artery grafts and 99.6 percent of saphenous-vein grafts.One or both study grafts were not placed in 17 patients owing to the presence of ungraftable coronary arteries in 4 patients, poor quality or length of the radial artery in 6 patients, poor vein quality in 2 patients, and various individual reasons in 5 patients. The protocol specified that these patients were to be excluded from the primary analysis because of protocol violations.
In 24 cases, a patient received both radial-artery and control saphenous-vein grafts but to the territory opposite that randomly allocated. The reasons for such crossovers were inadvertent error by the surgeon in the case of 19 patients and concern about the size or quality of the radial artery in 5 cases. In the analysis of the primary end point, all these patients were analyzed according to the intention to treat rather than the treatment received.
Postoperative Management
The majority of patients (94.1 percent) were discharged while taking a calcium-channel blocker, and this treatment was continued for three to six months in 90.0 percent of patients. Other medications at discharge included aspirin in 92.3 percent, other antithrombotic medications in 8.7 percent, lipid-lowering drugs in 66.7 percent, and beta-blockers in 70.6 percent of patients. At 12 months, 91.9 percent of patients were taking aspirin and 64.9 percent were taking a lipid-lowering drug.
Angiography at One Year
Follow-up angiography was performed in 440 of 561 randomized patients (78.4 percent). Reasons for not undergoing angiography included protocol violations in 17 patients (as described above), postoperative death before follow-up began in 8 patients, a new postoperative condition precluding the performance of research angiography in 19 patients, and late withdrawal of consent in 77 patients. In 9 of the 440 patients who underwent postoperative angiography, there was a clinical indication for the procedure. Angiography was performed a mean (±SD) of 4.7±2.4 months after surgery in these 9 patients and a mean of 10.9±4.3 months after surgery among the 431 patients who underwent angiography for research purposes alone.
Primary Analysis
The primary end point of complete graft occlusion occurred in 13.6 percent of saphenous-vein grafts and 8.2 percent of radial-artery grafts (60 of 440 vs. 36 of 440, P=0.009 by McNemar's test) according to the intention-to-treat analysis (Table 3Table 3
Angiographic End Points.). This corresponds to an absolute difference of 5.4 percent (95 percent confidence interval, 5.0 to 5.8 percent) and a reduction in the relative risk of graft occlusion of 40 percent (95 percent confidence interval, 28 to 52 percent) with radial-artery grafting, as compared with saphenous-vein grafting. When analyzed according to the treatment received, the results were nearly identical. In total, both study grafts were patent in 350 patients, both study grafts were occluded in 6 patients, only the radial-artery graft was occluded in 30 patients, and only the saphenous-vein graft was occluded in 54 patients.The angiographic string sign was present in 7.0 percent of radial-artery grafts and 0.9 percent of saphenous-vein grafts (31 of 440 vs. 4 of 440, P=0.001). Target coronary-vessel lesions with stenosis of 90 percent or greater, as compared with those with stenosis of 70 percent to 89 percent, were associated with a lower rate of occlusion of the radial-artery graft (Table 3) and a lower rate of the string sign in radial-artery grafts (3.7 percent vs. 12.4 percent, P<0.001). The relative patency of either radial-artery or saphenous-vein grafts did not depend on the bypassed native vessel.
Among patients with patent study grafts, some degree of angiographic stenosis was present at the proximal anastomosis in 21.4 percent of radial-artery grafts and 11.1 percent of saphenous-vein grafts (75 of 350 vs. 39 of 350, P<0.001). Some degree of angiographic stenosis was present in the graft body in 5.7 percent of radial-artery grafts and 12.3 percent of saphenous-vein grafts (20 of 350 vs. 43 of 350, P=0.003). There was no significant difference in the incidence of angiographic evidence of stenosis at the distal anastomosis between radial-artery grafts (49 of 350, or 14.0 percent) and saphenous-vein grafts (62 of 350, or 17.7 percent).
Adverse Events
One patient required readmission because of infection at the site at which the radial artery was harvested. One patient had a hand-questionnaire score greater than 18, implying clinically significant functional limitation. Thirty-two patients (5.7 percent) reported moderate-to-severe symptoms of thenar paresthesia or numbness at 1 month, and this number had decreased to six (1.1 percent) at the 12-month follow-up assessment. Ten patients (1.8 percent) reported moderate-to-severe weakness of the hand at 1 month, and this number had decreased to five (0.9 percent) at the 12-month follow-up assessment. No patient reported hand claudication or ischemia. There were no reports of adverse events during follow-up angiography.
Clinical End Points
Clinical follow-up information was available for all study patients for the first year (Table 4Table 4
Clinical Outcomes among the 561 Patients.). The one-year survival rate was 98.6 percent (553 of 561 patients). Nonfatal perioperative myocardial infarction occurred in 9.8 percent of patients (55 of 561). The infarct location was in the territory of the radial-artery graft in 3.2 percent of patients, the control saphenous-vein graft in 3.0 percent, and internal-thoracic-artery grafts in 2.8 percent and was indeterminate in 0.7 percent of patients.No patient underwent cardiac surgery a second time. Among four patients who underwent percutaneous coronary intervention, intervention was performed on one radial-artery graft at the proximal anastomosis, on two control saphenous-vein grafts, and on one native coronary artery distal to the insertion of a control saphenous-vein graft. At one year, the overall rate of the composite end point of death from cardiac causes, nonfatal myocardial infarction, or repeated revascularization was 11.6 percent.
Discussion
In this large, randomized, multicenter clinical trial, radial-artery bypass grafts had a higher rate of patency at one year than did the usual saphenous-vein graft, thus establishing radial-artery grafts as a second arterial conduit for targets other than the left anterior descending coronary artery. Previous studies have established the superiority of the left internal thoracic artery over saphenous-vein grafts for revascularization of the left anterior descending coronary artery.10 A recent observational series showed reduced patency of the radial-artery graft as compared with that of other conduits.5 However, that study did not use standardized surgical methods and concurrent pharmacotherapy, randomized controls, or routine angiographic follow-up, leading to potential bias in ascertainment and follow-up. In contrast, our study relied on a randomized design with routine angiographic follow-up. The study design was novel in that each patient received both the study radial-artery graft and the control saphenous-vein graft, thereby avoiding inherent bias regarding patient selection. Since the target vessel was randomly assigned, the effect of target-vessel location on graft patency could be analyzed independently. Grafting to either the left circumflex or right coronary territory did not influence patency in this study.
The relationship between the severity of proximal native-vessel stenosis and arterial-graft patency has been previously reported for internal-thoracic, gastroepiploic, and radial-artery grafts in retrospective studies.11-13 Certain characteristics of the radial artery, including the increased wall thickness and the density and organization of myocytes, may increase the propensity of this artery for spasm when there is decreased or competitive flow.14 Accordingly, we placed the radial artery in demanding situations by stipulating that the proximal target-vessel stenosis exceed 70 percent. Despite this inclusion criterion, a decrement in performance of radial-artery grafts was still evident in the form of higher rates of both occlusion and the angiographic string sign when they were used to bypass less severely stenotic target lesions. Fortunately, investigators have shown that inducible ischemia is uncommon in myocardial territories supplied by grafts with an angiographic string sign.15 The patency of these grafts may also improve late in follow-up, as native-vessel stenosis progresses.16
There were rare complications of harvesting of radial arteries in our study. A previous, larger study involving the harvesting of nearly 4000 radial arteries for coronary bypass grafting reported similarly low rates of complications of the hand and arm.17
The incidence of occlusion in the control saphenous-vein graft at one year was 13.6 percent, consistent with previous studies of the patency of saphenous-vein grafts showing one-year occlusion rates between 10 and 15 percent.18-20 Follow-up of patients with vein grafts has revealed a substantial incidence of atherosclerotic changes in the graft body, leading to hemodynamically significant stenoses at 10 years, with angiographic evidence of patency in only 50 to 60 percent of grafts21 — a rate that is sharply lower than late patency rates of more than 95 percent for the left internal thoracic artery.22,23 The increased incidence of angiographic stenoses in vein-graft bodies, as compared with radial-artery–graft bodies in our study, suggests that even during a one-year follow-up period, atherosclerotic changes are more apparent in vein grafts. Given the natural history of accelerated atherosclerosis in vein grafts, we speculate that the superiority of radial-artery conduits over vein grafts may be even greater at 5 and 10 years of follow-up. A small observational study recently showed a 10-year patency rate of 91 percent for radial-artery grafts.24 Five-year angiographic follow-up of patients in our trial is currently under way.
Although our study was designed to include patients at low risk for radial-artery atherosclerosis, inadequate size or quality of the radial artery precluded its use in six patients. Concern about the size or quality of the radial artery caused the surgeon to deviate from the randomized target vessel in an additional five patients. The incidence of an inadequate radial artery owing to atherosclerotic changes would probably be higher in the general population of candidates for coronary bypass, particularly among patients with severe peripheral vascular disease.
In conclusion, radial-artery grafts had a higher rate of patency than saphenous-vein grafts at one year in this multicenter trial. Surgeons can confidently use the radial artery as a second arterial bypass graft, particularly in patients with severe native-vessel stenosis.
Supported by a grant (MT-13883) from the Canadian Institutes of Health Research. Dr. Desai is the recipient of a Canadian Institutes of Health Research Fellowship and a Tailored Advanced Collaborative Training in Cardiovascular Science Fellowship.
Source Information
From the Divisions of Cardiac Surgery (N.D.D., S.E.F.), Cardiology (E.A.C.), and General Internal Medicine (C.D.N.), Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto.
Address reprint requests to Dr. Fremes at Sunnybrook and Women's College Health Sciences Centre, Rm. H410 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada, or at stephen.fremes@sw.ca.
Appendix
The members of the Radial-Artery Patency Study Group are as follows (all institutions are in Canada unless otherwise specified): Executive Committee — S.E. Fremes, E.A. Cohen, C.D. Naylor, N.D. Desai, R. Feder-Elituv; Manuscript Committee — N.D. Desai, E.A. Cohen, C.D. Naylor, S.E. Fremes; Steering Committee — S.E. Fremes, E.A. Cohen, C.D. Naylor, M. Carrier, G. Cote, D. Doyle, O. Gleaton, R. Masters, L. Higginson, L. Errett, K. Watson, S. Lichtenstein, R. Carere, M.L. Myers, D. Almond; Participating Cardiologists — D. Almond (Victoria Hospital, London, Ont.), C. Buller (University of British Columbia, Vancouver), F. Charbonneau (McGill University, Montreal), E.A. Cohen (University of Toronto, Toronto), C. Constance (McGill University, Montreal), G. Cote (Montreal Heart Institute, Montreal), J. Ducas (Health Sciences Centre, Winnipeg, Man.), O. Gleeton (Hôpital Laval, Sainte-Foy, Que.), L. Higginson (University of Ottawa Heart Institute, Ottawa), L. Schwartz (University of Toronto, Toronto), W. Tymchak (University of Alberta Hospital, Edmonton), R. Watson (University of Toronto, Toronto), G. Devlin (Waikato Hospital, Hamilton, New Zealand); Data Committee — N.D. Desai, H.R. Mallidi, R. Feder-Elituv (all at University of Toronto, Toronto); Statisticians — J.P. Szalai, M. Katik, K. Sykora, A. Kiss (all at University of Toronto, Toronto); Angiographic Committee — E.A. Cohen, J. Dubbin, S. Radhakrishnan, A. Adelman (deceased), L. Schwartz (all at the University of Toronto, Toronto); Clinical End-Points Committee — Z. Sasson (University of Toronto, Toronto), P. Dorian (University of Toronto, Toronto), K. Teoh (McMaster University, Hamilton, Ont.); Electrocardiogram Committee — G. Newton, Z. Wullfart, R. Myers, E. Crystal (all at the University of Toronto, Toronto); Data and Safety Monitoring Committee — S. Brister, C. Morgan, S. Logan (all at the University of Toronto, Toronto); Investigators (the number of patients recruited is in parentheses): Hôpital Laval, Sainte-Foy, Que.: D. Doyle (2), D. Desaulniers (2), R. Baillot (1), G. Raymond (6), M. Lemieux (6), P. Cartier (deceased) (2); Institute de Cardiologie de Montreal, Montreal: R. Cartier (2), M. Carrier (6), Y. Leclerc (1); London Health Sciences Center — University Campus, London, Ont.: A. Menkis (4), D. Boyd (24), R. Novick (2); London Health Sciences Center — Victoria Campus, London, Ont.: M.L. Myers (20); Montreal General Hospital, Montreal: D. Shum-Tim (1), J.F. Morin (48); Sunnybrook and Women's College Health Sciences Centre, Toronto: B. Goldman (14), C. Cutrara (32), G. Bhatnagar (39), S.E. Fremes (108), G.T. Christakis (43), L. Abouzhar (16); Health Sciences Centre, Winnipeg, Man.: D. Del Rizzo (10); St. Michael's Hospital, Toronto: D. Bonneau (6), D. Latter (23), L. Errett (11); Toronto General Hospital, Toronto: C. Peniston (4), H. Scully (1), R. Weisel (22), R.J. Cusimano (1), S. Brister (3), T. Ralph-Edwards (1), T. Yau (9); University of Alberta Hospital, Edmonton: E. Gelfand (8), P. Penkoske (2); University of Ottawa Heart Institute, Ottawa: F. Rubens (26); Vancouver Hospital and Health Sciences Centre, Vancouver, B.C.: G. Fradet (25), L. Burr (14), D. Thompson (2); Waikato Hospital, Hamilton, New Zealand: R. Ullal (14); Site Coordinators — M. Aleggretti, A.M. Powel, H. Brochu, R. Feder-Elituv, R. Fox, L. Lepicq, G. Keuen, C. Jessina, S. Finlay, E. Reeves, A. MacDonald, M. El-Tawil, L. Paul, M.A. James, L. Verreault, B. Weller, C. Nacario, J. Wilson, D. Penny, F. Denis, A. Munoz, L. Montebruno.
- References
References
1
Carpentier A ,Guermonprez JL ,Deloche A ,Frechette C ,DuBost C . The aorta-to-coronary radial artery bypass graft: a technique avoiding pathological changes in grafts. Ann Thorac Surg 1973;16:111-121
CrossRef | Medline2
Curtis JJ ,Stoney WS ,Alford WC Jr ,Burrus GR ,Thomas CS Jr . Intimal hyperplasia: a cause of radial artery aortocoronary bypass graft failure. Ann Thorac Surg 1975;20:628-635
CrossRef | Web of Science | Medline3
Chiu CJ . Why do radial artery grafts for aortocoronary bypass fail? A reappraisal. Ann Thorac Surg 1976;22:520-523
CrossRef | Web of Science | Medline4
Acar C ,Jebara VA ,Portoghese M , et al. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 1992;54:652-659
CrossRef | Web of Science | Medline5
Khot UN ,Friedman DT ,Pettersson G ,Smedira NG ,Li J ,Ellis SG . Radial artery bypass grafts have an increased occurrence of angiographically severe stenosis and occlusion compared with left internal mammary arteries and saphenous vein grafts. Circulation 2004;109:2086-2091
CrossRef | Web of Science | Medline6
Fremes SE . Multicenter Radial Artery Patency Study (RAPS): study design. Control Clin Trials 2000;21:397-413
CrossRef | Medline7
Fremes SE ,Christakis GT ,Del Rizzo DF ,Musiani A ,Mallidi H ,Goldman BS . The technique of radial artery bypass grafting and early clinical results. J Card Surg 1995;10:537-544
CrossRef | Web of Science | Medline8
Hudak PL ,Amadio PC ,Bombardier C . Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand). Am J Ind Med 1996;29:602-608[Erratum, Am J Ind Med 1996;30:372.]
CrossRef | Web of Science | Medline9
Chesebro JH ,Knatterud G ,Roberts R , et al. Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: a comparison between intravenous tissue plasminogen activator and intravenous streptokinase: clinical findings through hospital discharge. Circulation 1987;76:142-154
CrossRef | Web of Science | Medline10
Loop FD ,Lytle BW ,Cosgrove DM , et al. Influence of the internal-mammary-artery graft on 10-year survival and other cardiac events. N Engl J Med 1986;314:1-6
Full Text | Web of Science | Medline11
Sabik JF III ,Lytle BW ,Blackstone EH ,Khan M ,Houghtaling PL ,Cosgrove DM . Does competitive flow reduce internal thoracic artery graft patency? Ann Thorac Surg 2003;76:1490-1496
CrossRef | Web of Science | Medline12
Uchida N ,Kawaue Y . Flow competition of the right gastroepiploic artery graft in coronary revascularization. Ann Thorac Surg 1996;62:1342-1346
CrossRef | Web of Science | Medline13
Moran SV ,Baeza R ,Guarda E , et al. Predictors of radial artery patency for coronary bypass operations. Ann Thorac Surg 2001;72:1552-1556
CrossRef | Web of Science | Medline14
Parolari A ,Rubini P ,Alamanni F , et al. The radial artery: which place in coronary operation? Ann Thorac Surg 2000;69:1288-1294
CrossRef | Web of Science | Medline15
Royse AG ,Royse CF ,Tatoulis J , et al. Postoperative radial artery angiography for coronary artery bypass surgery. Eur J Cardiothorac Surg 2000;17:294-304
CrossRef | Web of Science | Medline16
Possati G ,Gaudino M ,Alessandrini F , et al. Midterm clinical and angiographic results of radial artery grafts used for myocardial revascularization. J Thorac Cardiovasc Surg 1998;116:1015-1021
CrossRef | Web of Science | Medline17
Meharwal ZS ,Trehan N . Functional status of the hand after radial artery harvesting: results in 3,977 cases. Ann Thorac Surg 2001;72:1557-1561
CrossRef | Web of Science | Medline18
Fremes SE ,Levinton C ,Naylor CD ,Chen E ,Christakis GT ,Goldman BS . Optimal antithrombotic therapy following aortocoronary bypass: a meta-analysis. Eur J Cardiothorac Surg 1993;7:169-180
CrossRef | Web of Science | Medline19
Grondin CM ,Lesperance J ,Bourassa MG ,Pasternac A ,Campneau L ,Grondin P . Serial angiographic evaluation in 60 consecutive patients with aorto-coronary artery vein grafts 2 weeks, 1 year, and 3 years after operation. J Thorac Cardiovasc Surg 1974;67:1-6
Web of Science | Medline20
FitzGibbon GM ,Burton JR ,Leach AJ . Coronary bypass graft fate: angiographic grading of 1400 consecutive grafts early after operation and of 1132 after one year. Circulation 1978;57:1070-1074
Web of Science | Medline21
Bourassa MG ,Campeau L ,Lesperance J ,Grondin CM . Changes in grafts and coronary arteries after saphenous vein aortocoronary bypass surgery: results at repeat angiography. Circulation 1982;65:90-97
CrossRef | Web of Science | Medline22
Zeff RH ,Kongtahworn C ,Iannone LA , et al. Internal mammary artery versus saphenous vein graft to the left anterior descending coronary artery: prospective randomized study with 10-year follow-up. Ann Thorac Surg 1988;45:533-536
CrossRef | Web of Science | Medline23
Lytle BW ,Loop FD ,Cosgrove DM ,Ratliff NB ,Easley K ,Taylor PC . Long-term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts. J Thorac Cardiovasc Surg 1985;89:248-258
Web of Science | Medline24
Possati G ,Gaudino M ,Prati F , et al. Long-term results of the radial artery used for myocardial revascularization. Circulation 2003;108:1350-1354
CrossRef | Web of Science | Medline
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Yuka Kondo, Akihito Muto, Fabio A. Kudo, Lynn Model, Sammy Eghbalieh, Paraag Chowdhary, Alan Dardik. (2011) Age-Related Notch-4 Quiescence is Associated with Altered Wall Remodeling During Vein Graft Adaptation. Journal of Surgical Research 171:1, e149-e160
CrossRef6
L. David Hillis, Peter K. Smith, Jeffrey L. Anderson, John A. Bittl, Charles R. Bridges, John G. Byrne, Joaquin E. Cigarroa, Verdi J. DiSesa, Loren F. Hiratzka, Adolph M. Hutter, Michael E. Jessen, Ellen C. Keeley, Stephen J. Lahey, Richard A. Lange, Martin J. London, Michael J. Mack, Manesh R. Patel, John D. Puskas, Joseph F. Sabik, Ola Selnes, David M. Shahian, Jeffrey C. Trost, Michael D. Winniford. (2011) 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. Journal of the American College of Cardiology
CrossRef7
L. David Hillis, Peter K. Smith, Jeffrey L. Anderson, John A. Bittl, Charles R. Bridges, John G. Byrne, Joaquin E. Cigarroa, Verdi J. DiSesa, Loren F. Hiratzka, Adolph M. Hutter, Michael E. Jessen, Ellen C. Keeley, Stephen J. Lahey, Richard A. Lange, Martin J. London, Michael J. Mack, Manesh R. Patel, John D. Puskas, Joseph F. Sabik, Ola Selnes, David M. Shahian, Jeffrey C. Trost, Michael D. Winniford. (2011) 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: Executive Summary. Journal of the American College of Cardiology
CrossRef8
Jose L. Navia, Nicolas Brozzi, Jorge Chiu, Eugene H. Blackstone, Gregory L. Hanson, Sharif Al-Ruzzeh, Bruce W. Lytle. (2011) Endoscopic versus open radial artery harvesting for coronary artery bypass grafting. Scandinavian Cardiovascular Journal 45:5, 279-285
CrossRef9
Giuseppe Ferrante, Patrizia Presbitero, Marco Valgimigli, Marie-Claude Morice, Paolo Pagnotta, Guido Belli, Elena Corrada, Yoshinobu Onuma, Peter Barlis, Didier Locca, Eric Eeckhout, Carlo Di Mario, Patrick Serruys. (2011) Percutaneous coronary intervention versus bypass surgery for left main coronary artery disease: a meta-analysis of randomised trials. EuroIntervention 7:6, 738-746
CrossRef10
Joon Bum Kim, Joon-Won Kang, Hyun Song, Sung Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee, Tae-Hwan Lim. (2011) Late improvement in graft patency after coronary artery bypass grafting: Serial assessment with multidetector computed tomography in the early and late postoperative settings. The Journal of Thoracic and Cardiovascular Surgery 142:4, 793-799
CrossRef11
Alexander Kulik, Pierre Voisine, Patrick Mathieu, Roy G. Masters, Thierry G. Mesana, Michel R. Le May, Marc Ruel. (2011) Statin Therapy and Saphenous Vein Graft Disease After Coronary Bypass Surgery: Analysis From the CASCADE Randomized Trial. The Annals of Thoracic Surgery 92:4, 1284-1291
CrossRef12
Kevin L. Greason, Hartzell V. Schaff. (2011) Myocardial Revascularization by Coronary Arterial Bypass Graft: Past, Present, and Future. Current Problems in Cardiology 36:9, 325-368
CrossRef13
Aron M. Trocchia, Warren C. Hammert. (2011) Arterial Grafts for Vascular Reconstruction in the Upper Extremity. The Journal of Hand Surgery 36:9, 1534-1536
CrossRef14
Sean OZ Bello, Edward WK Peng, Pradip K Sarkar. (2011) Conduits for coronary artery bypass surgery: the quest for second best. Journal of Cardiovascular Medicine 12:6, 411-421
CrossRef15
Seshasayee Narasimhan, Vankeepuram S. Srinivas, Joseph John DeRose. (2011) Hybrid Coronary Revascularization. Cardiology in Review 19:3, 101-107
CrossRef16
A. Muto, T. Yi, K. D. Harrison, A. Davalos, T. T. Fancher, K. R. Ziegler, A. Feigel, Y. Kondo, T. Nishibe, W. C. Sessa, A. Dardik. (2011) Eph-B4 prevents venous adaptive remodeling in the adult arterial environment. Journal of Experimental Medicine 208:3, 561-575
CrossRef17
Irem Mueed, Tracy Tazzeo, Lindsay Doharris, Tariq Aziz, Victor Chu, Luke J. Janssen. (2011) Reduction of arterial graft smooth muscle mass by moderate heat therapy. Translational Research 157:3, 128-138
CrossRef18
Stefano Lucchina, Alexandru Nistor, Hans Stricker, Cesare Fusetti. (2011) False aneurysm of the common digital artery. Is reconstruction with an arterial graft worth the efforts? A case report. Microsurgery 31:3, 246-250
CrossRef19
Mitsumasa Hata, Isamu Yoshitake, Shinji Wakui, Satoshi Unosawa, Haruka Kimura, Hiroaki Hata, Motomi Shiono. (2011) Long-Term Patency Rate for Radial Artery vs. Saphenous Vein Grafts Using Same-Patient Materials. Circulation Journal 75:6, 1373-1377
CrossRef20
Jack C.J. Sun, Kevin H.T. Teoh, Andre Lamy, Tej Sheth, Mary Lou Ellins, Hyejung Jung, Salim Yusuf, Sonia Anand, Stuart Connolly, Richard P. Whitlock, John W. Eikelboom. (2010) Randomized trial of aspirin and clopidogrel versus aspirin alone for the prevention of coronary artery bypass graft occlusion: the Preoperative Aspirin and Postoperative Antiplatelets in Coronary Artery Bypass Grafting study. American Heart Journal 160:6, 1178-1184
CrossRef21
Susumu Manabe, Toshihiro Fukui, Minoru Tabata, Tomoki Shimokawa, Satoshi Morita, Shuichiro Takanashi. (2010) Arterial graft deterioration one year after coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 140:6, 1306-1311
CrossRef22
Stefanos Demertzis, Rafael Trunfio, Francesco Faletra, Rolf Wyttenbach, Francesco Siclari. (2010) Sutureless Proximal Anastomosis Using the PAS-Port System: Six-Month Patency and Five-Year Follow-Up in “All-Comers”. The Annals of Thoracic Surgery 90:5, 1507-1513
CrossRef23
, , W. Wijns, P. Kolh, N. Danchin, C. Di Mario, V. Falk, T. Folliguet, S. Garg, K. Huber, S. James, J. Knuuti, J. Lopez-Sendon, J. Marco, L. Menicanti, M. Ostojic, M. F. Piepoli, C. Pirlet, J. L. Pomar, N. Reifart, F. L. Ribichini, M. J. Schalij, P. Sergeant, P. W. Serruys, S. Silber, M. Sousa Uva, D. Taggart, , A. Vahanian, A. Auricchio, J. Bax, C. Ceconi, V. Dean, G. Filippatos, C. Funck-Brentano, R. Hobbs, P. Kearney, T. McDonagh, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirnes, M. Tendera, P. E. Vardas, P. Widimsky, , P. Kolh, O. Alfieri, J. Dunning, S. Elia, P. Kappetein, U. Lockowandt, G. Sarris, P. Vouhe, , P. Kearney, L. von Segesser, S. Agewall, A. Aladashvili, D. Alexopoulos, M. J. Antunes, E. Atalar, A. Brutel de la Riviere, A. Doganov, J. Eha, J. Fajadet, R. Ferreira, J. Garot, J. Halcox, Y. Hasin, S. Janssens, K. Kervinen, G. Laufer, V. Legrand, S. A. M. Nashef, F.-J. Neumann, K. Niemela, P. Nihoyannopoulos, M. Noc, J. J. Piek, J. Pirk, Y. Rozenman, M. Sabate, R. Starc, M. Thielmann, D. J. Wheatley, S. Windecker, M. Zembala. (2010) Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal 31:20, 2501-2555
CrossRef24
Robert F. Tranbaugh, Kamellia R. Dimitrova, Patricia Friedmann, Charles M. Geller, Loren J. Harris, Paul Stelzer, Bertram Cohen, Darryl M. Hoffman. (2010) Radial Artery Conduits Improve Long-Term Survival After Coronary Artery Bypass Grafting. The Annals of Thoracic Surgery 90:4, 1165-1172
CrossRef25
Christos Voucharas, Apostolos Bisbos, Pavlos Moustakidis, Nikolaos Tsilimingas. (2010) Open Versus Tunneling Radial Artery Harvest for Coronary Artery Grafting. Journal of Cardiac Surgery 25:5, 504-507
CrossRef26
Tamer Elghobary, Jean-Francois Légaré. (2010) What has happened to multiple arterial grafting in coronary artery bypass grafting surgery?. Expert Review of Cardiovascular Therapy 8:8, 1099-1105
CrossRef27
D. N. Moris, F. C. Sigala, S. E. Georgopoulos, I. P. Bramis. (2010) The choice of the appropriate graft in the treatment of vascular diseases. Hellenic Journal of Surgery 82:4, 274-283
CrossRef28
Kristian Bartnes, Stig E. Hermansen, Øystein Dahl-Eriksen, Amjid Iqbal, Jan T. Mannsverk, Terje K. Steigen, Thor Trovik, Rolf Busund, Per E. Dahl, Dag G. Sørlie, Truls Myrmel. (2010) Radial artery graft patency relates to gender, diabetes mellitus and angiotensin inhibition. Scandinavian Cardiovascular Journal 44:4, 230-236
CrossRef29
T. Yonetsu, T. Kakuta, T. Lee, K. Takayama, K. Kakita, T. Iwamoto, N. Kawaguchi, K. Takahashi, G. Yamamoto, Y. Iesaka, H. Fujiwara, M. Isobe. (2010) Assessment of acute injuries and chronic intimal thickening of the radial artery after transradial coronary intervention by optical coherence tomography. European Heart Journal 31:13, 1608-1615
CrossRef30
Kamellia R. Dimitrova, Darryl M. Hoffman, Charles M. Geller, Helbert DeCastro, Bill Dienstag, Robert F. Tranbaugh. (2010) Endoscopic Radial Artery Harvest Produces Equivalent and Excellent Midterm Patency Compared With Open Harvest. Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 5:4, 265-269
CrossRef31
Paul Achouh, Redha Boutekadjirt, Daniel Toledano, Nadjib Hammoudi, Jean-Yves Pagny, Pascal Goube, Khaled Ould Isselmou, Bernard Lancelin, Régis Fouquet, Christophe Acar. (2010) Long-term (5- to 20-year) patency of the radial artery for coronary bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 140:1, 73-79.e2
CrossRef32
Cathy Jeon, Susana C. Candia, John C. Wang, Elizabeth M. Holper, Michelle Ammerer, Richard E. Kuntz, Laura Mauri. (2010) Relative spatial distributions of coronary artery bypass graft insertion and acute thrombosis: A model for protection from acute myocardial infarction. American Heart Journal 160:1, 195-201
CrossRef33
Christian H. Møller, Mario J. Perko, Jens T. Lund, Lars W. Andersen, Henning Kelbæk, Jan K. Madsen, Christian Gluud, Daniel A. Steinbrüchel. (2010) Graft patency after off-pump versus on-pump coronary artery surgery in high-risk patients. Scandinavian Cardiovascular Journal 44:3, 161-167
CrossRef34
Hisato Takagi, Masafumi Matsui, Takuya Umemoto. (2010) Total occlusion and string sign of radial artery versus saphenous vein graft conduits: An updated meta-analysis. The Journal of Thoracic and Cardiovascular Surgery 139:6, 1671-1672
CrossRef35
Anoar Zacharias, Thomas A. Schwann, Christopher J. Riordan, Samuel J. Durham, Aamir S. Shah, Milo Engoren, Robert H. Habib. (2010) Late outcomes after radial artery versus saphenous vein grafting during reoperative coronary artery bypass surgery. The Journal of Thoracic and Cardiovascular Surgery 139:6, 1511-1518.e4
CrossRef36
Guanghui Pan, Zheng Chen, Dehuai Liao, Jiali Fang, Guanghui Li. (2010) The Application of the Iliac Artery in the Ex Vivo Reconstruction of Renal Arteries in Renal Transplantation. Transplantation 89:9, 1113-1116
CrossRef37
Akshay Desai, Frederic S. Resnic. (2010) Highlights from American Heart Association Annual Scientific Sessions 2009: Orlando, Florida, November 14–18, 2009. The Journal of Thoracic and Cardiovascular Surgery 139:4, 1090-1092
CrossRef38
Jeffrey J. Popma, Senthil Nathan, Robert C. Hagberg, Kamal R. Khabbaz. (2010) Hybrid myocardial revascularization: An integrated approach to coronary revascularization. Catheterization and Cardiovascular Interventions 75:S1, S28-S34
CrossRef39
Steve K. Singh, Nimesh D. Desai, Genta Chikazawa, Hiroshi Tsuneyoshi, Jessica Vincent, Brandon M. Zagorski, Visal Pen, Fuad Moussa, Gideon N. Cohen, George T. Christakis, Stephen E. Fremes. (2010) The Graft Imaging to Improve Patency (GRIIP) clinical trial results. The Journal of Thoracic and Cardiovascular Surgery 139:2, 294-301.e1
CrossRef40
Umberto Benedetto, Emiliano Angeloni, Simone Refice, Riccardo Sinatra. (2010) Radial artery versus saphenous vein graft patency: Meta-analysis of randomized controlled trials. The Journal of Thoracic and Cardiovascular Surgery 139:1, 229-231
CrossRef41
Anoar Zacharias, Robert H. Habib. (2009) Reply. The Annals of Thoracic Surgery 88:5, 1725
CrossRef42
Dusko Nezic, Aleksandar Knezevic, Slobodan Micovic, Miomir Jovic. (2009) Is There Any Prospective, Randomized Study to Confirm Significantly Better Angiographic Radial Artery Conduit Patency Compared With Saphenous Vein Graft Patency?. The Annals of Thoracic Surgery 88:5, 1724-1725
CrossRef43
I.C. Ennker, D. Pietrowski, L. Vöhringer, B. Kojcici, A. Albert, P.M. Vogt, J. Ennker. (2009) Surgical debridement, vacuum therapy and pectoralis plasty in poststernotomy mediastinitis. Journal of Plastic, Reconstructive & Aesthetic Surgery 62:11, 1479-1483
CrossRef44
Andrew P Gratrix, James D Atkinson, Andrew R Bodenham. (2009) Cannulation of the impalpable section of radial artery: preliminary clinical and ultrasound observations. European Journal of Anaesthesiology 26:10, 887-889
CrossRef45
Vinod Jorapur, Antonio Cano-Gomez, Cesar A. Conde. (2009) Should Saphenous Vein Grafts be the Conduits of Last Resort for Coronary Artery Bypass Surgery?. Cardiology in Review 17:5, 235-242
CrossRef46
Joseph John DeRose. (2009) Current State of Integrated “Hybrid” Coronary Revascularization. Seminars in Thoracic and Cardiovascular Surgery 21:3, 229-236
CrossRef47
Emile N. Brown, Nicholas S. Burris, Zachary N. Kon, Michael C. Grant, Philip S. Brazio, Chenyang Xu, Patrick Laird, Junyen Gu, Seeta Kallam, Pranjal Desai, Robert S. Poston. (2009) Intraoperative detection of intimal lipid in the radial artery predicts degree of postoperative spasm. Atherosclerosis 205:2, 466-471
CrossRef48
Donald D. Glower. (2009) Invited Commentary. The Annals of Thoracic Surgery 88:1, 39
CrossRef49
Daniel Hänggi, Michael Reinert, Hans-Jakob Steiger. (2009) C-Port Flex-A–assisted automated anastomosis for high-flow extracranial-intracranial bypass surgery in patients with symptomatic carotid artery occlusion: a feasibility study. Journal of Neurosurgery 111:1, 181-187
CrossRef50
Sung-Ho Jung, Hyun Song, Suk Jung Choo, Hyung Gon Je, Cheol Hyun Chung, Joon-Won Kang, Jae Won Lee. (2009) Comparison of radial artery patency according to proximal anastomosis site: Direct aorta to radial artery anastomosis is superior to radial artery composite grafting. The Journal of Thoracic and Cardiovascular Surgery 138:1, 76-83
CrossRef51
John D. Puskas, Michael E. Halkos, Husam Balkhy, Michael Caskey, Mark Connolly, John Crouch, Anno Diegeler, Jan Gummert, Wolfgang Harringer, Valavanur Subramanian, Francis Sutter, Klaus Matschke. (2009) Evaluation of the PAS-Port Proximal Anastomosis System in coronary artery bypass surgery (the EPIC trial). The Journal of Thoracic and Cardiovascular Surgery 138:1, 125-132
CrossRef52
Thomas A. Schwann, Anoar Zacharias, Christopher J. Riordan, Samuel J. Durham, Aamir S. Shah, Robert H. Habib. (2009) Sequential Radial Artery Grafts for Multivessel Coronary Artery Bypass Graft Surgery: 10-Year Survival and Angiography Results. The Annals of Thoracic Surgery 88:1, 31-39
CrossRef53
Tomoki Shimokawa, Susumu Manabe, Takahiro Sawada, Shigefumi Matsuyama, Toshihiro Fukui, Shuichiro Takanashi. (2009) Intermediate-Term Patency of Saphenous Vein Graft With a Clampless Hand-Sewn Proximal Anastomosis Device After Off-pump Coronary Bypass Grafting. The Annals of Thoracic Surgery 87:5, 1416-1420
CrossRef54
Richard D. Kenagy, Nozomi Fukai, Seung-Kee Min, Florencia Jalikis, Ted R. Kohler, Alexander W. Clowes. (2009) Proliferative capacity of vein graft smooth muscle cells and fibroblasts in vitro correlates with graft stenosis. Journal of Vascular Surgery 49:5, 1282-1288
CrossRef55
Changqing Gao, Ming Yang, Yang Wu, Gang Wang, Cangsong Xiao, Hongbin Liu, Caiyi Lu. (2009) Hybrid Coronary Revascularization by Endoscopic Robotic Coronary Artery Bypass Grafting on Beating Heart and Stent Placement. The Annals of Thoracic Surgery 87:3, 737-741
CrossRef56
Giuseppe Santarpino, Francesco Onorati, Cristian Scalas, Marco Gori, Lucia Cristodoro, Saverio Zofrea, Attilio Renzulli. (2009) Radial artery achieves better flowmetric results than saphenous vein in the elderly. Heart and Vessels 24:2, 108-115
CrossRef57
Pirouz Parang, Rohit Arora. (2009) Coronary vein graft disease: Pathogenesis and prevention. Canadian Journal of Cardiology 25:2, e57-e62
CrossRef58
Charalambos Antoniades, Shafi Mussa, Cheerag Shirodaria, Justin Lee, Jonathan Diesch, David P. Taggart, Keith M. Channon, Paul Leeson. (2009) Relation of Preoperative Radial Artery Flow-Mediated Dilatation to Nitric Oxide Bioavailability in Radial Artery Grafts Used in Off-Pump Coronary Artery Bypass Grafting. The American Journal of Cardiology 103:2, 216-220
CrossRef59
Aleksandar Redzek, Zivojin Jonjev. (2009) Radial artery in myocardial revascularization. Medicinski pregled 62:5-6, 241-247
CrossRef60
Benjamin Medalion, Avraham Fuks, Erez Sharoni, Alon Stamler, Eitan Snir, Bernardo Vidne, Eyal Porat. (2008) Limb performance and patient satisfaction after radial artery harvesting: endoscopic versus open techniques. Surgical Endoscopy 22:12, 2638-2642
CrossRef61
Philip S. Brazio, Patrick C. Laird, Chenyang Xu, Junyan Gu, Nicholas S. Burris, Emile N. Brown, Zachary N. Kon, Robert S. Poston. (2008) Harmonic scalpel versus electrocautery for harvest of radial artery conduits: Reduced risk of spasm and intimal injury on optical coherence tomography. The Journal of Thoracic and Cardiovascular Surgery 136:5, 1302-1308
CrossRef62
Ferdinando Varbella, Andrea Gagnor, Francesco Tomassini, Vincenzo Infantino, Maria Rosa Conte. (2008) Immediate and long-term results of treatment of complex lesions of the left anterior descending coronary artery involving a large diagonal branch with drug-eluting stents. Journal of Cardiovascular Medicine 9:11, 1088-1094
CrossRef63
S. Damgaard, J. Wetterslev, J. T. Lund, N. B. Lilleor, M. J. Perko, H. Kelbaek, J. K. Madsen, D. A. Steinbruchel. (2008) One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial. European Heart Journal 30:8, 1005-1011
CrossRef64
M. Ranucci, A. Ballotta, A. Frigiola, A. Boncilli, S. Brozzi, E. Costa, R. H. Mehta. (2008) Pre-operative homocysteine levels and morbidity and mortality following cardiac surgery. European Heart Journal 30:8, 995-1004
CrossRef65
Bob Kiaii, R. Scott McClure, Peter Stewart, Reiza Rayman, Stuart A. Swinamer, Yoshihiro Suematsu, Stephanie Fox, Jennifer Higgins, Caroline Albion, William J. Kostuk, David Almond, Kumar Sridhar, Patrick Teefy, George Jablonsky, Pantelis Diamantouros, Wojciech B. Dobkowski, Philip Jones, Daniel Bainbridge, Ivan Iglesias, John Murkin, Davy Cheng, Richard J. Novick. (2008) Simultaneous integrated coronary artery revascularization with long-term angiographic follow-up. The Journal of Thoracic and Cardiovascular Surgery 136:3, 702-708
CrossRef66
Sabine Bleiziffer, Ina Hettich, Birgit Eisenhauer, Daniel Ruzicka, Bernhard Voss, Robert Bauernschmitt, Ruediger Lange. (2008) Neurologic sequelae of the donor arm after endoscopic versus conventional radial artery harvesting. The Journal of Thoracic and Cardiovascular Surgery 136:3, 681-687
CrossRef67
David Glineur, Claude Hanet, Alain Poncelet, William D'hoore, Jean-Christophe Funken, Jean Rubay, Parla Astarci, Valerie Lacroix, Robert Verhelst, Pierre Yves Etienne, Philippe Noirhomme, Gebrine El Khoury. (2008) Comparison of saphenous vein graft versus right gastroepiploic artery to revascularize the right coronary artery: A prospective randomized clinical, functional, and angiographic midterm evaluation. The Journal of Thoracic and Cardiovascular Surgery 136:2, 482-488
CrossRef68
Francesco Burzotta, Carlo Trani, Martial Hamon, Giovanni Amoroso, Ferdinand Kiemeneij. (2008) Transradial approach for coronary angiography and interventions in patients with coronary bypass grafts: Tips and tricks. Catheterization and Cardiovascular Interventions 72:2, 263-272
CrossRef69
Junjiro Kobayashi. (2008) Current status of coronary artery bypass grafting. General Thoracic and Cardiovascular Surgery 56:6, 260-267
CrossRef70
Chee Fui Chong, Anthony De Souza. (2008) Significance of radial artery anomalies in coronary artery bypass graft surgery. The Journal of Thoracic and Cardiovascular Surgery 135:6, 1389-1390
CrossRef71
Willem J.L. Suyker, Cornelius Borst. (2008) Coronary Connector Devices: Analysis of 1,469 Anastomoses in 1,216 Patients. The Annals of Thoracic Surgery 85:5, 1828-1836
CrossRef72
Sune Damgaard, Jens T. Lund, Nikolaj B. Lilleør, Mario J. Perko, Kåre Sander, Blagoja Dimo, Maiken B. Jensen, Jan K. Madsen, Henning Kelbæk, Daniel A. Steinbrüchel. (2008) Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial. The Journal of Thoracic and Cardiovascular Surgery 135:5, 1069-1075
CrossRef73
Rajendra H. Mehta, John H. Alexander, Robert Emery, Stephen J. Ellis, Vic Hasselblad, Ahmad Khalil, Michel Carrier, Robert A. Harrington, Jean-Claude Tardif. (2008) A randomized, double-blind, placebo-controlled, multicenter study to evaluate the cardioprotective effects of MC-1 in patients undergoing high-risk coronary artery bypass graft surgery: MC-1 to Eliminate Necrosis and Damage in Coronary Artery Bypass Graft Surgery Trial (MEND-CABG) II—study design and rationale. American Heart Journal 155:4, 600-608
CrossRef74
Nicholas S. Burris, Emile N. Brown, Michael Grant, Zachary N. Kon, Marc Gibber, Junyen Gu, Kimberly Schwartz, Seeta Kallam, Ashish Joshi, Richard Vitali, Robert S. Poston. (2008) Optical Coherence Tomography Imaging as a Quality Assurance Tool for Evaluating Endoscopic Harvest of the Radial Artery. The Annals of Thoracic Surgery 85:4, 1271-1277
CrossRef75
Robert H. Habib. (2008) Optimal target vessel stenosis for radial artery grafting. The Journal of Thoracic and Cardiovascular Surgery 135:2, 463
CrossRef76
Hasan Kocaeli, Norberto Andaluz, Ondrej Choutka, Mario Zuccarello. (2008) Use of radial artery grafts in extracranial–intracranial revascularization procedures. Neurosurgical FOCUS 24:2, E5
CrossRef77
Zachary N. Kon, Emile N. Brown, Richard Tran, Ashish Joshi, Barry Reicher, Michael C. Grant, Seeta Kallam, Nicholas Burris, Ingrid Connerney, David Zimrin, Robert S. Poston. (2008) Simultaneous hybrid coronary revascularization reduces postoperative morbidity compared with results from conventional off-pump coronary artery bypass. The Journal of Thoracic and Cardiovascular Surgery 135:2, 367-375
CrossRef78
Mitchell J. Magee, John H. Alexander, Gail Hafley, T. Bruce Ferguson, C. Michael Gibson, Robert A. Harrington, Eric D. Peterson, Robert M. Califf, Nicholas T. Kouchoukos, Morley A. Herbert, Michael J. Mack. (2008) Coronary Artery Bypass Graft Failure After On-Pump and Off-Pump Coronary Artery Bypass: Findings From PREVENT IV. The Annals of Thoracic Surgery 85:2, 494-500
CrossRef79
F. Crusco, A. Antoniella, V. Papa, D. Lazzaro, T. Ragni, A. Giovagnoni. (2007) Multidetector CT and coronary artery bypass grafts. La radiologia medica 112:8, 1087-1099
CrossRef80
Nimesh D Desai, Stephen E Fremes. (2007) Radial artery conduit for coronary revascularization: as good as an internal thoracic artery?. Current Opinion in Cardiology 22:6, 534-540
CrossRef81
Francesco Onorati, Francesco Pezzo, Maria Caterina Comi, Barbara Impiombato, Antonio Esposito, Massimo Polistina, Attilio Renzulli. (2007) Radial artery graft function is not affected by age. The Journal of Thoracic and Cardiovascular Surgery 134:5, 1112-1120.e3
CrossRef82
Ramin Malekan, Steven L. Lansman. (2007) Surgical Treatment of Heart Failure in the Elderly. Heart Failure Clinics 3:4, 501-509
CrossRef83
Sabine Bleiziffer, Ina Hettich, Birgit Eisenhauer, Daniel Ruzicka, Michael Wottke, Joerg Hausleiter, Stefan Martinoff, Martin Morgenstern, Ruediger Lange. (2007) Patency rates of endoscopically harvested radial arteries one year after coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 134:3, 649-656
CrossRef84
Philip A.R. Hayward, Brian F. Buxton. (2007) Contemporary Coronary Graft Patency: 5-Year Observational Data From a Randomized Trial of Conduits. The Annals of Thoracic Surgery 84:3, 795-799
CrossRef85
Bikram P. Choudhary, Charalambos Antoniades, Alison F. Brading, Antony Galione, Keith Channon, David P. Taggart. (2007) Diabetes Mellitus as a Predictor for Radial Artery Vasoreactivity in Patients Undergoing Coronary Artery Bypass Grafting. Journal of the American College of Cardiology 50:11, 1047-1053
CrossRef86
Cristiano O. Cardoso, La Hore C. Rodrigues, Carlos R. Cardoso, Luis Maria C. Yordi. (2007) Impact of Radial Artery Cannulation on Radial Artery Function. The American Journal of Cardiology 100:4, 743-744
CrossRef87
E. W. Muriithi, N. Alphonso, J. B. Barnard, J. A. J. Hyde, W. B. Pugsley, U. H. Trivedi, A. T. Forsyth. (2007) Early to Midterm Results With the Radial Artery in Coronary Artery Bypass Grafting Following Autotransplantation Without Pharmacological Manipulation. Journal of Cardiac Surgery 22:4, 323-327
CrossRef88
Peter Bergmann, Katharina Meszaros, Stefan Huber, Peter Oberwalder, Heinrich Mächler, Gottfried Schaffler, Rainer Rienmueller, Bruno Rigler. (2007) Forty-one-month follow-up of the Symmetry aortic connector system for proximal venous anastomosis. The Journal of Thoracic and Cardiovascular Surgery 134:1, 23-28
CrossRef89
Cornelis J. Botman, Jacques Schonberger, Sjaak Koolen, Olaf Penn, Hilde Botman, Nabil Dib, Eric Eeckhout, Nico Pijls. (2007) Does Stenosis Severity of Native Vessels Influence Bypass Graft Patency? A Prospective Fractional Flow Reserve–Guided Study. The Annals of Thoracic Surgery 83:6, 2093-2097
CrossRef90
F. Crusco, A. Antoniella, V. Papa, R. Menzano, D. Lazzaro, G. Manici, T. Ragni, A. Giovagnoni. (2007) Midterm follow-up of patients receiving radial artery as coronary artery bypass grafts using 16-detector-row CT coronary angiography. La radiologia medica 112:4, 538-549
CrossRef91
Deowall Chattar-Cora. (2007) Forearm Muscle Necrosis After Radial Artery Harvesting for Coronary Artery Bypass Surgery. The Annals of Thoracic Surgery 83:5, 1869-1870
CrossRef92
Guglielmo Bernardi, Giorgio Morocutti, Leonardo Spedicato, Davide Zanuttini. (2007) The value of clinical wisdom in randomised studies, real-world registries and new hypotheses. Journal of Cardiovascular Medicine 8:5, 313-317
CrossRef93
K. Knobloch, S. Tomaszek, K. H. Busch, P. M. Vogt. (2007) Palmar microcirculation does not deteriorate 2 years after radial artery harvesting—implications for reconstructive free forearm flap transfer. Langenbeck's Archives of Surgery 392:3, 315-322
CrossRef94
Xavier M. Mueller, David Greentree, Michel Nguyen, Oliver Reuthebuch, Michele Genoni. (2007) Introduction of an OPCAB Program Aimed at Total Arterial Grafting in a Multidisciplinary Setting: Feasible and Safe?. Journal of Cardiac Surgery 22:2, 87-94
CrossRef95
Tim A. Fischell, David R. Holmes. (2007) Late DES thrombosis: A lot of smoke, very little fire?. Catheterization and Cardiovascular Interventions 69:4, 609-615
CrossRef96
Alexander Kulik, Fraser D. Rubens, Derek Gunning, Michael E. Bourke, Thierry G. Mesana, Marc Ruel. (2007) Radial Artery Graft Treatment With Phenoxybenzamine is Clinically Safe and May Reduce Perioperative Myocardial Injury. The Annals of Thoracic Surgery 83:2, 502-509
CrossRef97
Jason M. Burstein, Dominica Gidrewicz, Stuart J. Hutchison, Kate Holmes, Sanjit Jolly, Warren J. Cantor. (2007) Impact of Radial Artery Cannulation for Coronary Angiography and Angioplasty on Radial Artery Function. The American Journal of Cardiology 99:4, 457-459
CrossRef98
Ramin Malekan, Steven L. Lansman. (2007) Surgical Treatment of Heart Failure in the Elderly. Clinics in Geriatric Medicine 23:1, 179-192
CrossRef99
Peter Alison, Andrew McKee. 2007. Surgery for Coronary Artery Disease. , 141-157.
CrossRef100
T. Aper, A. Schmidt, M. Duchrow, H.-P. Bruch. (2007) Autologous Blood Vessels Engineered from Peripheral Blood Sample. European Journal of Vascular and Endovascular Surgery 33:1, 33-39
CrossRef101
Kaoru Matsuura, Junjiro Kobayashi, Ko Bando, Kazuo Niwaya, Osamu Tagusari, Hiroyuki Nakajima, Soichiro Kitamura. (2006) Redo off-pump coronary bypass grafting with arterial grafts for Kawasaki disease. Heart and Vessels 21:6, 361-364
CrossRef102
Naoto Miyagi, Nagahisa Oshima, Toshizumi Shirai, Makoto Sunamori. (2006) Skeletonized harvesting improves the early-term and mid-term perfect patency of a radial artery graft. The Japanese Journal of Thoracic and Cardiovascular Surgery 54:11, 472-476
CrossRef103
Hiroshi Banno, Yoshifumi Takei, Takashi Muramatsu, Kimihiro Komori, Kenji Kadomatsu. (2006) Controlled release of small interfering RNA targeting midkine attenuates intimal hyperplasia in vein grafts. Journal of Vascular Surgery 44:3, 633-641
CrossRef104
Domingos S.R. Souza, Benny Johansson, Leif Bojö, Roland Karlsson, Håkan Geijer, Derek Filbey, Lennart Bodin, Mikael Arbeus, Michael R. Dashwood. (2006) Harvesting the saphenous vein with surrounding tissue for CABG provides long-term graft patency comparable to the left internal thoracic artery: Results of a randomized longitudinal trial. The Journal of Thoracic and Cardiovascular Surgery 132:2, 373-378.e5
CrossRef105
Xinjiang Cai, Neil J Freedman. (2006) New therapeutic possibilities for vein graft disease in the post-edifoligide era. Future Cardiology 2:4, 493-501
CrossRef106
Oz M. Shapira, Benjamin R. Eskenazi, Curtis T. Hunter, Elad Anter, Yusheng Bao, Richard Murphy, Harold L. Lazar, Richard J. Shemin. (2006) Endoscopic Versus Conventional Radial Artery Harvest-Is Smaller Better?. Journal of Cardiac Surgery 21:4, 329-335
CrossRef107
Davide Di Lazzaro, Temistocle Ragni, Gino Di Manici, Giuliana Bardelli, Uberto Da Col, Francesco Grasselli, Amedeo Antoniella, Walter Papa, Federico Crusco, Andrea Giovagnoni. (2006) Noninvasive Midterm Follow-Up of Radial Artery Bypass Grafts With 16-Slice Computed Tomography. The Annals of Thoracic Surgery 82:1, 44-50
CrossRef108
Karsten Knobloch, Sandra Tomaszek, Artur Lichtenberg, Matthias Karck, Axel Haverich. (2006) Long-Term Palmar Microcirculation After Radial Artery Harvesting: An Observational Study. The Annals of Thoracic Surgery 81:5, 1700-1707
CrossRef109
Kandice Kottke-Marchant, Coby Larsen. 2006. Vascular Graft Prosthesis. .
CrossRef110
Lokeswara Rao Sajja, Gopichand Mannam. (2006) Reply. The Annals of Thoracic Surgery 81:4, 1551-1552
CrossRef111
Dusko G. Nezic, Aleksandar M. Knezevic, Miomir Dj. Jovic, Sasa D. Borovic. (2006) Angiographic Patency of the Radial Artery Conduit in Coronary Artery Bypass Grafting. The Annals of Thoracic Surgery 81:4, 1551
CrossRef112
D. J. Clark, B. Chan, A. Rosalion, P. Shah, B. Buxton. (2006) 'Pseudo' coronary graft stenosis from radial artery spasm. Internal Medicine Journal 36:4, 263-264
CrossRef113
Armand Mekontso-Dessap, Matthias Kirsch, Christophe Guignambert, Patricia Zadigue, Serge Adnot, Daniel Loisance, Saadia Eddahibi. (2006) Vascular-wall remodeling of 3 human bypass vessels: Organ culture and smooth muscle cell properties. The Journal of Thoracic and Cardiovascular Surgery 131:3, 651-658
CrossRef114
Oz M. Shapira, Benjamin R. Eskenazi, Elad Anter, Lija Joseph, Thomas G. Christensen, Curtis T. Hunter, Harold L. Lazar, Joseph A. Vita, Richard J. Shemin, John F. Keaney. (2006) Endoscopic versus conventional radial artery harvest for coronary artery bypass grafting: Functional and histologic assessment of the conduit. The Journal of Thoracic and Cardiovascular Surgery 131:2, 388-394
CrossRef115
Senri Miwa, Nimesh Desai, Tadaaki Koyama, Emily Chan, Eric A. Cohen, Stephen E. Fremes. (2006) Radial Artery Angiographic String Sign: Clinical Consequences and the Role of Pharmacologic Therapy. The Annals of Thoracic Surgery 81:1, 112-119
CrossRef116
Brian Buxton. (2006) Diffuse Coronary Artery Disease and Dystrophic Calcification of the Radial Artery-Is There an Association?. Journal of Cardiac Surgery 21:1, 101-101
CrossRef117
Önder Teskin, B. Sönmez Uydeş-Doǧan, Yavuz Enç, F. İlkay Alp, Deniz Kaleli, Süheyla Keser, Taner İyigün, Fuat Bilgen, Sabri Daǧsalı, Osman Özdemir. (2006) Comparative Effects of Tolazoline and Nitroprusside on Human Isolated Radial Artery. The Annals of Thoracic Surgery 81:1, 125-131
CrossRef118
Susumu Manabe, Makoto Sunamori. (2006) Radial Artery Graft for Coronary Artery Bypass Surgery: Biological Characteristics and Clinical Outcome. Journal of Cardiac Surgery 21:1, 102-114
CrossRef119
HARTMUT OSTER, FRANZ SCHWARZ, HANS STORGER, MANFRED HOFMANN, CLAUDIA PIANCATELLI, JULE THOMAS, JURGEN HAASE. (2005) One-Year Clinical Outcomes After Complete Arterial Coronary Revascularization. Journal of Interventional Cardiology 18:6, 437-440
CrossRef120
José M. González Santos, Javier López Rodríguez, María J. Dalmau Sorlí. (2005) Los injertos arteriales en cirugía coronaria: ¿una terapia universal?. Revista Española de Cardiología 58:10, 1207-1223
CrossRef121
Hideki Kitamura, Hitoshi Okabayashi, Michiya Hanyu, Yoshiharu Soga, Takuya Nomoto, Hiroyuki Johno, Jota Nakano, Takehiko Matsuo, Masashi Kai, Eitaro Umehara. (2005) Early and midterm patency of the proximal anastomoses of saphenous vein grafts made with a Symmetry Aortic Connector System. The Journal of Thoracic and Cardiovascular Surgery 130:4, 1028-1031
CrossRef122
Brian F. Buxton, Manoj Durairaj, David L. Hare, Ian Gordon, Simon Moten, Victoria Orford, Siven Seevanayagam. (2005) Do Angiographic Results From Symptom-Directed Studies Reflect True Graft Patency?. The Annals of Thoracic Surgery 80:3, 896-901
CrossRef123
Karsten Knobloch, Artur Lichtenberg, Sandra Tomaszek, Christian Hagl, Nawid Khaladj, Uwe Klima, Axel Haverich. (2005) Long-Term Physical Activity and Neurologic Function After Harvesting of the Radial Artery as T-Graft or Free Graft in Coronary Revascularization. The Annals of Thoracic Surgery 80:3, 918-921
CrossRef124
Shafi Mussa, Bikram P. Choudhary, David P. Taggart. (2005) Reply to the Editor:. The Journal of Thoracic and Cardiovascular Surgery 130:1, 233
CrossRef125
Anoar Zacharias, Robert H. Habib, Thomas A. Schwann, Christopher J. Riordan, Samuel J. Durham, Aamir Shah. (2005) Radial artery conduits in coronary artery bypass grafting: Current perspective. The Journal of Thoracic and Cardiovascular Surgery 130:1, 232-233
CrossRef126
Floyd D. Loop. (2005) Coronary Artery Surgery. The Annals of Thoracic Surgery 79:6, S2221-S2227
CrossRef127
Thoralf M Sundt. (2005) Technology Insight: randomized trials of off-pump versus on-pump coronary artery bypass surgery. Nature Clinical Practice Cardiovascular Medicine 2:5, 261-268
CrossRef128
(2005) Radial-Artery Coronary Bypass Grafts. New England Journal of Medicine 352:9, 941-942
Full Text129
James Tatoulis. (2005) Do radial-artery grafts have a superior 1-year patency to saphenous-vein grafts?. Nature Clinical Practice Cardiovascular Medicine 2:3, 126-127
CrossRef130
D. Nezic, P. Milojevic, M. Cirkovic, A. Knezevic, A. Novakovic, Lj. Gojkovic-Bukarica, M. Jovic, B. Djukanovic. (2005) The radial artery for coronary artery bypass grafting. Acta chirurgica iugoslavica 52:3, 11-19
CrossRef131
Lytle, Bruce W., . (2004) Prolonging Patency — Choosing Coronary Bypass Grafts. New England Journal of Medicine 351:22, 2262-2264
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