It is a well-known fact that the internal mammary artery (IMA) is the best conduit for use in coronary artery bypass graft (CABG) surgery. It has a patency of 95% at 5 years and beyond. Till now the 2nd conduit being used in over 90% cases (in USA and UK) was the saphenous vein graft (SVG). While this is easy to harvest – but its long-term patency decreases markedly over time to less than 50% at 10 years.
Thus the search was on for a graft better than the SVG. The right IMA is excellent but again not used by the majority of surgeons (in USA and UK) because of fear of sternal infection. The radial artery (RA) has been used since 1989 but was never proven clearly to be better than the SVG. All previous trials (Radial Artery Patency Study RAPS and the Radial Artery vs Saphenous Vein Patency Trial RSVP) through showing superiority over SVG and noninferiority over RIMA were underpowered.…
