Total Arterial vs. Mixed Grafting in Left Coronary CABG

NCT07057713 | Not Yet Recruiting

• 1 other identifier: JDEYXWK208
• Study Type: interventional
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

This is a prospective, randomized, double-blind controlled trial comparing the clinical efficacy of total arterial grafting (internal thoracic artery and radial artery) versus conventional mixed grafting (internal thoracic artery and great saphenous vein) in the left coronary artery system during coronary artery bypass grafting (CABG). A total of 400 patients undergoing elective CABG at the Second Hospital of Jilin University will be enrolled and randomized into two groups. The primary endpoint is graft patency at 12 months postoperatively, evaluated by coronary angiography or CT angiography. Secondary outcomes include perioperative complications, major adverse cardiovascular events (MACE), and long-term clinical prognosis. The study aims to provide evidence-based guidance on optimal graft selection in CABG.

Conditions

Coronary Artery Disease; Coronary Artery Bypass Grafting; Arterial Graft; Graft Patency; Major Adverse Cardiovascular Events

Outcome Measures

Primary Outcomes (1)

• Graft Patency Rate

  Graft patency will be assessed at 12 months after surgery by coronary angiography or coronary CT angiography. A patent graft is defined as one with \<50% stenosis and continuous flow. The proportion of patients with all coronary artery grafts remaining patent will be calculated and compared between groups.

  12 months after surgery

Secondary Outcomes (2)

• Incidence of Major Adverse Cardiovascular Events

  Within 12 months after surgery

• Incidence of Perioperative Complications

  Within 30 days after surgery

Study Arms (2)

Total Arterial Grafting Group

EXPERIMENTAL

Patients in this group will undergo coronary artery bypass grafting (CABG) with total arterial grafts to the left coronary artery system. The left internal thoracic artery (LITA) will be grafted to the left anterior descending artery (LAD), and the radial artery will be anastomosed to the obtuse marginal or diagonal branches of the circumflex artery. The right coronary artery, if revascularized, will receive a conventional vein graft.

Procedure: Total Arterial Grafting

Conventional Mixed Grafting Group

ACTIVE COMPARATOR

Patients in this group will receive conventional mixed grafting during CABG. The left internal thoracic artery (LITA) will be used for the LAD, while the great saphenous vein will be grafted to other branches of the left coronary artery system, such as the obtuse marginal or diagonal branches. The right coronary artery, if revascularized, will also be grafted using a vein.

Procedure: Conventional Mixed Grafting

Interventions

Total Arterial Grafting PROCEDURE

Coronary artery bypass grafting using only arterial conduits in the left coronary artery system. The left internal thoracic artery (LITA) is grafted to the LAD, and the radial artery is anastomosed to the obtuse marginal or diagonal branches. This approach avoids the use of saphenous vein grafts for the left coronary system.

Also known as: LITA + Radial Artery Grafting

Total Arterial Grafting Group

Conventional Mixed Grafting PROCEDURE

A standard coronary artery bypass grafting (CABG) procedure where the left internal thoracic artery (LITA) is grafted to the LAD, and saphenous vein grafts are used for the obtuse marginal or diagonal branches of the left coronary system. This approach represents the conventional mixed arterial-venous strategy.

Also known as: Mixed Arterial-Venous Grafting

Conventional Mixed Grafting Group

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 18 years
• Diagnosed with multivessel coronary artery disease
• Indicated for elective coronary artery bypass grafting (CABG) involving ≥3 coronary vessels
• Right coronary artery stenosis \>75%
• Able and willing to provide written informed consent

You may not qualify if:

• Scheduled for concurrent cardiac procedures (e.g., valve surgery, congenital heart disease repair, aortic dissection surgery, atrial fibrillation ablation)
• Severe stenosis of left or right subclavian artery
• Unsuitable saphenous veins (e.g., bilateral varicosities)
• Unsuitable radial artery as assessed preoperatively
• History of intracranial hemorrhage or ischemic stroke within the past 14 days
• Severe hepatic or renal insufficiency
• Acute myocardial infarction within 72 hours prior to surgery
• History of prior CABG or other cardiac surgery

Sponsors & Collaborators

• Second Hospital of Jilin University: lead

Study Sites (1)

The Second Hospital of Jilin University

Changchun, Jilin, 130000, China

Location

MeSH Terms

Conditions

Coronary Artery Disease

Condition Hierarchy (Ancestors)

Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

Study Officials

• Kexiang Liu

  Department of Cardiovascular Surgery, The Second Hospital of Jilin University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

kexiang liu

CONTACT

17390920328; kxliu64@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants and outcome assessors will be blinded to the grafting strategy. The surgical team will not be blinded due to the nature of the intervention, but outcome evaluation will be conducted by independent, blinded assessors.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Patients undergoing elective CABG will be randomized 1:1 to receive either total arterial grafting or conventional mixed grafting in the left coronary system.

Study Record Dates

• First Submitted: June 29, 2025
• First Posted: July 10, 2025
• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): August 1, 2027
• Study Completion (Estimated): December 30, 2027
• Last Updated: April 23, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)