Effect of arterial revascularisation on survival: a systematic review of studies comparing bilateral and single internal mammary arteries.
D P Taggart, R D'Amico, D G Altman
https://pubmed.ncbi.nlm.nih.gov/11567701/Actively Recruiting
Led by Weill Medical College of Cornell University · Updated on 2026-04-01
2300
Participants Needed
146
Research Sites
N/A
Total Duration
Researchers are evaluating the outcomes of different coronary artery bypass grafting techniques in women with heart disease. The trial compares multiple arterial grafting MAG to single arterial grafting SAG to see if using multiple arterial grafts improves major heart and brain-related events and quality of life. This international randomized clinical trial includes 2,300 women to assess differences in survival, stroke, heart attacks, repeat surgeries, and hospital readmissions, as well as physical and mental health. Participants will be randomly assigned to one of two groups. One group receives a single arterial graft using the left internal thoracic artery plus additional venous grafts. The other group receives multiple arterial grafts, including the left internal thoracic artery and at least one other arterial graft such as the right internal thoracic artery or radial artery, with possible additional arterial grafts. The study uses the infrastructure of an existing trial and follows patients for at least 2.5 years after surgery. During the study, researchers collect data on major adverse cardiac and cerebrovascular events, along with quality of life measured by general and disease-specific questionnaires. Physical and mental health symptoms are also assessed. Follow-up includes tracking deaths, strokes, heart attacks, repeat procedures, and hospital stays. The trial aims to provide detailed information on outcomes and quality of life in women undergoing coronary bypass surgery over a long-term period.
CONDITIONS
Comparison of the Outcomes of Single vs Multiple Arterial Grafts in Women
M
Mario Gaudino, Prof/PhD/MD
S
Stephen Fremes, Prof/MD
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Weill Medical College of Cornell University
Lead Sponsor
New York Presbyterian Hospital
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Multiple Arterial Graft — left and right internal thoracic or radial artery plus additional grafts | Single Arterial Graft — left internal thoracic artery plus venous grafts |
|---|---|---|
| What it is | Participants receive the left internal thoracic artery graft to the left anterior descending artery, and a second arterial graft (right internal thoracic or radial artery) to a major circumflex branch. Additional targets can get venous or arterial grafts. | Participants receive the left internal thoracic artery graft to the left anterior descending artery. All other coronary targets are revascularized with venous grafts. |
| Role in the trial | Serves as the investigational arm, evaluating the potential benefits of additional arterial conduits beyond standard SAG. | Serves as one of the randomized arms and represents a common standard approach in isolated CABG. |
| Primary use | Multiple arterial grafting is used to increase arterial supply, typically adding a right internal thoracic or radial artery graft. This approach seeks improved long-term outcomes by using more arterial conduits. | Single arterial grafting is widely used for coronary artery bypass in women, prioritizing proven long-term patency of the left internal thoracic artery. |
| How it is given or performed | Surgical procedure involves harvesting the left internal thoracic artery for the left anterior descending artery and a second arterial conduit (right internal thoracic or radial artery) for the circumflex vessels. Additional grafts placed as per anatomy. | Surgical procedure involves harvesting the left internal thoracic artery and grafting it to the left anterior descending artery. Venous grafts are placed for other coronary targets. |
| Evidence status | Meta-analyses and guidelines show that using two arterial grafts (especially bilateral internal thoracic arteries) may improve long-term survival and reduce major adverse cardiac events, especially in younger or lower-risk patients. | Left internal thoracic artery grafting has extensive long-term outcome evidence, supporting its use as the primary graft in CABG. |
| Important limitations | Multiple arterial grafting can add surgical complexity and may increase early procedural risk or technical demands. Longer operative times and risk of wound complications (sternal infection) have been reported, especially in selected high-risk patients. | Single arterial grafting relies on venous conduits for all other targets, which may have lower long-term patency and higher risk for graft failure compared with arterial grafts. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Up to hospital discharge or until wound closure
Participants undergo coronary artery bypass grafting with either a single arterial graft or multiple arterial grafts, followed by immediate post-operative care.
1 surgical procedure and several in-hospital visits
Duration - Minimum 2.5 years
Participants are followed for recovery, monitoring major adverse cardiac and cerebrovascular events, quality of life, and physical and mental health symptoms.
Regular follow-up visits over 2.5 years
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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https://pubmed.ncbi.nlm.nih.gov/3484393/Weill Medical College of Cornell University
Lead Sponsor
New York Presbyterian Hospital
Collaborating Sponsor