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Page 18 of 22 Royse et al. Vessel Plus 2020;4:5 I http://dx.doi.org/10.20517/2574-1209.2019.34

revascularisation would demonstrate magnified significant differences, or converted non-significant to
significant differences. There is a strong logical basis to propose new PCI vs. CABG (TAR) trials.

CONCLUSION
To increase the use of arterial grafts by initially substituting arterial conduits for venous conduits - but not
altering the techniques of the surgeon - is a simple and pragmatic approach toward routine total arterial
revascularisation. To achieve universal arterial graft use, a stepwise approach, practising the various
sequential and Y graft methods, should be initially undertaken in elective and low risk surgery to minimise
stress on the operating team.

DECLARATIONS
Authors’ contributions
Authored this manuscript based on the work of many other studies and publications including manuscript
design, writing, incorporation of prior analyses and of clinical opinion offered: Royse A
Co-authored all of the referenced studies and was involved in study design, execution and analysis in all:
Royse C
Contributed to data collection and analysis in all of the studies referenced: Boggett S
Involved in the analysis of all of the studies referenced and co-written all: Clarke-Errey S
Involved in writing, data collection, data analysis and study design of the original study for the comparison
of total arterial revascularisation and use of saphenous vein graft published in the European Journal of
Cardiothoracic Surgery: Pawanis Z

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

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