Why is this study important?

• Conflicting data regarding durability of the free radial artery (RA) graft as a non-left internal thoracic artery (LITA/LIMA) conduit in CABG procedures 
• Long-term (>15 year) follow-up 
• Two randomized trials in one study: RAPCO-RITA – RA vs. FRITA (free right internal thoracic artery) and RAPCO-SV – RA vs. SVG (saphenous vein graft) 

What question was this study supposed to answer?

Is a free RA graft a durable conduit for CABG?

What did the study show?

• In the RAPCO-RITA study, randomization was 196 in RA arm and 198 in the RITA arm. > 88 % were men and 11 % were diabetics in both groups
• The left circumflex was grafted in approximately 2/3rd of cases and the right coronary in approximately 1/3rd of cases 
• RA graft had a better outcome than RITA with Absolute 9% and Relative 26% risk reduction in MACE (P=0.04) and an Absolute 8% and Relative 31% reduction in mortality (P=0.06) 
• In the RAPCO-SVG study, randomization was 113 in the RA arm and 112 in the SVG arm. > 81 % were men and 45 % were diabetics 
• The Left circumflex was grafted in approximately 2/3rd of cases and the right coronary in approximately 1/3rd of cases   
• There was Absolute 13% and Relative 29% risk reduction in MACE (P=0.04) and Absolute 13% and Relative 29% reduction in mortality (P=0.08)  
• Both studies did not address Instrumented radial arteries as satisfactory CABG conduits 

Conclusions

• Long-term (> 15 year) results of two integrated trials demonstrating better clinical outcomes using RA grafting compared with both RITA and SV 
• Currently < 10 of CABG procedures use RA graft. This study supports the use of RA graft as an arterial conduit in CABG