Optimal Graft Selection in CABG: Comparative Outcomes of Radial Artery and Saphenous Vein Grafts

By: Sajidah AlSaihati, Rowad AlKhaleej International School

Coronary artery bypass grafting (CABG) treats advanced coronary artery disease by using healthy vessels to reroute blood flow around blocked arteries. Graft choice strongly influences long-term outcomes, and graft failure drives much of the morbidity and mortality associated with CABG. This study compares radial-artery grafts (RAG) and saphenous vein grafts (SVG) in terms of patency, mortality, and postoperative outcomes, aiming to inform surgical decision-making. The study uses an evaluative comparative analysis, drawing on data from peer-reviewed studies and trials published between 2014 and 2026, to examine adult patients undergoing CABG with either RAG or SVG. It uses tabulated measures of postoperative complication incidence, mean graft patency, and mortality at 1, 5, and 10 years to identify patterns across the included research. Across most studies, RAG showed higher mean long-term patency and fewer postoperative complications than SVG. Mortality differences were less consistent, especially in early follow-up. Overall, RAG appears to offer advantages over SVG in durability and complication profiles.