© 2005 by BMJ Publishing Group & British Cardiac Society
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ISCHAEMIC HEART DISEASE
In the past decade, the radial artery has frequently been used for coronary bypass surgery, despite concern regarding the possibility of graft spasm. The investigators enrolled 561 patients at 13 centres. 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 8–12 months postoperatively. Angiography was performed at one year in 440 patients: 8.2% of radial artery grafts and 13.6% of saphenous vein grafts were completely occluded (p = 0.009). Diffuse narrowing of the graft (the angiographic "string sign") was present in 7.0% of radial artery grafts and only 0.9% of saphenous vein grafts (p = 0.001). The absence of severe native vessel
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