Radial artery vs right internal thoracic artery vs saphenous vein as the second conduit for coronary artery bypass surgery: A network meta-analysis of clinical outcomes
Journal of the American Heart Association Jan 17, 2019
Gaudino M, et al. - Researchers searched for the second-best conduit after the internal thoracic artery in coronary artery bypass grafting by analyzing evidence from adjusted observational studies and randomized controlled trials comparing the radial artery (RA), saphenous vein (SV), and/or right internal thoracic artery (RITA) as the second conduit for coronary artery bypass grafting, focusing on all-cause long-term mortality as well as on operative mortality, perioperative stroke, perioperative myocardial infarction, and deep sternal wound infection (DSWI). These studies were identified from MEDLINE and EMBASE. They analyzed overall 149,902 patients (4 randomized, 31 observational studies; RA, 16,201, SV, 112,018, RITA, 21,683). According to findings, compared with the SV, the use of the RA or the RITA was related to a similar and statistically significant long-term clinical benefit. The comparison of 2 arterial conduits revealed no differences in operative risk or complications, but DSWI continued to be a concern with bilateral ITA when skeletonization was not used.
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