Which statement best describes the advantages and limitations of radial artery versus saphenous vein grafts?

• A. SVG is versatile and easier to harvest but has worse long-term patency.
• B. Radial artery has worse patency than SVG; SVG has more vasospasm.
• C. Radial artery offers better long-term patency than SVG but has higher vasospasm risk and requires careful conduit selection; SVG is versatile and easier to harvest but has worse long-term patency.
• D. Radial artery is never used due to vasospasm.

Answer: (C)

Conduits in CABG are chosen to maximize long-term graft function while balancing surgical risks. The radial artery, being an arterial conduit, tends to maintain patency longer than a saphenous vein graft when used in appropriate targets and with proper flow dynamics. Its drawback is a higher risk of vasospasm due to its muscular wall, so it requires careful conduit selection, thoughtful target vessel choice, and use of vasodilators to prevent spasm, along with preoperative hand circulation assessment (like an Allen test) to ensure adequate collateral flow. The saphenous vein graft is versatile and easier to harvest, useful for reaching multiple targets, but its long-term patency is worse because veins are more prone to vein graft disease and atherosclerotic changes over time.

Therefore, the best description is that radial artery offers better long-term patency than SVG but has higher vasospasm risk and requires careful conduit selection; SVG is versatile and easier to harvest but has worse long-term patency.