Trend toward improved survival seen with SITA+RA for zero- to five-year survival and for BITA after 10 years
THURSDAY, Feb. 5, 2026 (HealthDay News) — For lower-risk patients undergoing coronary artery bypass grafting (CABG) for multivessel disease, radial artery plus one internal thoracic artery (SITA+RA) and bilateral ITA (BITA) utilization is increasing, with survival generally comparable through 15 years, according to a study presented at the annual meeting of the Society of Thoracic Surgeons, held from Jan. 29 to Feb. 1 in New Orleans.
Thomas Schwann, M.D., of Corewell Health William Beaumont University Hospital in Royal Oak, Michigan, and colleagues examined the comparative effectiveness of the main multiarterial bypass grafting platforms SITA+RA versus BITA among adult patients younger than 90 years old undergoing first, nonemergency isolated CABG for multivessel disease (81,719 and 76,496 patients, respectively).
The researchers found that during the past decade in the United States, the frequency of multiarterial CABG increased (9 to >16 percent), mainly due to increased SITA+RA and a modest increase in BITA. Prematching survival was uniformly excellent in unadjusted analyses and was incrementally better in BITA than SITA+RA. Further survival benefit was seen in association with a third arterial conduit. In a propensity score-matched analysis involving 66,237 pairs, equivalent BITA and SITA+RA 15-year survival were demonstrated in all patients. There was balance between superior BITA survival in younger patients and improved SITA+RA survival in patients aged 70 years or older. There was a trend toward improved zero- to five-year survival with SITA+RA in landmark analyses, while BITA trended better after 10 years. Compared with both SITA+RA and BITA grafting strategies, adding additional conduits (BITA+RA) was associated with similarly decreased risk-adjusted mortality.
“Given the improved survival associated with additional arterial grafts beyond two, this should encourage and challenge surgeons to use as many arterial grafts as possible to optimize outcomes,” Schwann said in a statement.
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