Blaise Pascal and the evidence on the use of multiple arterial grafts for coronary artery bypass surgery after the interim analysis of the Arterial Revascularization Trial

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Purpose of review

After the publication of the interim analysis of the ART, we review the contradiction between the large numbers of observational studies published on the course of over 25 years and the randomized trials comparing the use of single versus multiple arterial grafts for coronary bypass surgery.

Recent findings

The Arterial Revascularization Trial (ART) found no difference in survival and event-free survival at 5 years between patients randomized to receive one or two internal thoracic arteries at the time of surgery.


At the moment, there is evidence that arterial grafts have higher patency rate than venous grafts and a possible protective effect on the coronary circulation. Arterial grafts are still a reasonable choice, especially in patients with long life expectancy. Further studies and the final results of ART are needed.

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