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Abstract The poor long term patency of vein grafts in the coronary circulation, and the gross atheromatous changes discovered at angiocatheterization and/or re-operation have been of concern to many surgeons . Studies have demonstrated that there are differences between venous and arterial grafts as follows: 1. Wall of vein derive their blood supply from the vasavasora whereas walls of arteries derive it, principally, by diffusion through their lumen in addition to little role done by it its vasovasora, which do not penetrate the media layers in the arteries. 2. The endothelial lining of arteries may be responsible of more endothelium-derived factors that resists migration and proliferation of fibroblasts as well as platelets hence causing more resistance to early and late graft occlusion. 3. The venous structure is usually accustomed to low pressure in contrast to arteries that is normally subjected to high pressure. 4. The endothelium of arteries may secret more endothelium derived relaxing factor These differences in the histological and functional architecture have impacted the current excellent patency rate of arterial graft and has granted it to rank highly superior to the venous graft in term of long lasting patency. Following approval by the ethics and research committee of Kasr el Ainy faculty of Medicine Cairo University, and obtaining an informed consent, a prospective randomized clinical study was conducted on FIFTY who were operated upon with CABG in the period between 1\11\2017 and 30\6\2019.Requiring in addition to LIMA to LAD revascularization of an oblique marginal. These patients included 25patients who received radial artery as the conduit. The selected patients for this study were evaluated postoperatively by MSCT angiography to comparative study between radial artery versus saphenous vein grafts patency after 5 years |