Which graft is associated with better long-term patency but higher risk of vasospasm?

• A. Radial artery.
• B. Saphenous vein graft.
• C. Internal jugular vein.
• D. Pulmonary artery graft.

Answer: (A)

In CABG, arterial grafts generally offer better long-term patency than vein grafts because arteries resist atherosclerosis and maintain stronger flow over time. However, they come with a higher tendency for vasospasm due to their muscular walls, which can reduce or stop blood flow to the graft in the early postoperative period. The radial artery exemplifies this trade-off: it provides superior long-term patency compared with a saphenous vein graft, but has a greater risk of vasospasm that clinicians manage with vasodilators and careful postoperative care. The other options don’t combine both improved long-term patency and a higher vasospasm risk in the same way, since vein grafts (like saphenous) have poorer long-term patency and aren’t as prone to vasospasm, and the remaining conduits are not standard CABG grafts with this characteristic profile.