The preclotting of porous arterial prostheses.
A four-step preclotting method is presented for use with porous filamentous Dacron prostheses in the fully-heparinized patient. The method employs controlled fibrin formation within graft interstices, heparin neutralization of all thrombin remaining in the graft wall, and delay of systemic heparin neutralization until 15--20 minutes after clamp release. The resulting flow surface is impervious, smooth and hypothrombogenic. Experimental data are presented which support the rationale of this four-step preclotting method. Four years of clinical experience with the method are summarized, involving 300 prosthesis limbs used in aortic bifurcation, aortofemoral, femorofemoral, axillary-femoral and femoropopliteal positions in 192 patients. A clinical perspective of preclotting techniques is presented in which the proper use of this new method is suggested.
D000818:Animals; D001769:Blood; D001777:Blood Coagulation; D001807:Blood Vessel Prosthesis / Q000379:methods*; D002339:Carotid Arteries / Q000601:surgery; D004285:Dogs; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D011093:Polyethylene Terephthalates
D011093:Polyethylene Terephthalates; D006493:Heparin