March 9, 2004
HOUSTON, TX - The Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) was recently selected as one of nine VA medical facilities in the United States to participate in a cooperative study examining radial artery versus saphenous vein grafts in coronary artery bypass grafting (CABG).
In the United States, CABG is a commonly performed surgical procedure for the treatment of coronary artery disease. Approximately 400,000 patients undergo this type of procedure each year and the vast majority of cases have blockages in all three major coronary arteries. This condition requires the physician to perform multiple bypasses during surgery.
Routine cases involve harvesting the left internal thoracic artery (LITA) from the chest wall or the greater saphenous vein (SVG) from the leg to use as conduits or channels for bypass. In other cases, doctors harvest the radial artery from the patient's forearm to use in the operation.
Each of these three types of blood vessel conduits or grafts have a different success rate in remaining open or unobstructed after CABG surgery. The best long-term results are achieved when the LITA graft bypasses the left anterior descending coronary artery, which is usually the largest and most important coronary artery in the heart. Whether the radial artery is better than the SVG as a coronary artery conduit remains to be proven. In this randomized study, patients learn the day before surgery whether the surgeon will harvest the radial artery from the forearm or use their saphenous vein to bypass the diseased coronary artery blockages.
The primary objective of this study is to determine if there is a difference in the graft patency (the level of being open or unobstructed) between radial artery and saphenous vein grafts. Physicians in this study believe radial artery grafts will have a nine percent improved graft patency at one year.
"We also want to determine if there are differences in radial artery versus saphenous vein graft in clinical outcomes, costs, and quality of life. Our goal, of course, is to provide the best possible medical and surgical care to our veterans, and we would like to know which graft lasts longer so we can offer this option to our patients" said Ernesto R. Soltero, M.D., chief, MEDVAMC Cardiothoracic Surgery Section and a principal investigator in this study.
In April 2003, the MEDVAMC enrolled its first patient in this nationwide, randomized clinical trial involving patients undergoing first time CABG surgery. This is a five-year study and the MEDVAMC will have at least 120 patients participating. To date, 17 patients have undergone coronary artery bypass surgery as study participants. The MEDVAMC research team consists of Soltero; Joseph Huh, M.D., MEDVAMC staff cardiothoracic surgeon and co-investigator; Issam Mikati, M.D., MEDVAMC cardiologist and co-investigator; and Pamela Smithwick, R.N., MEDVAMC study coordinator.
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Point of Contact: VHAHOU Public Affairs03/09/04 10:29