New prostheses for venous substitution.
In 81 Beagle dogs, 6 cm long segments of the inferior vena cava were replaced end-to-end by artificial vascular grafts (10 mm in diameter) without an av-fistula and anticoagulant drugs. Different graft materials have been used, such as various e-PTFE (30-90 microns fiber length) and polyurethane with low and increased microporosity. e-PTFE with 75 microns fiber length and polyurethane with increased porosity showed the best tissue incorporation, complete endothelialization of the whole length and a high patency rate of 80-85% after a follow-up of 12 months. In contrast to other commercially available vascular grafts (textile woven or knitted, e-PTFE 30 microns) tested in previous series, polyurethane and e-PTFE with increased microporosity had already achieved complete endothelialization after 6-12 weeks. Therefore, these optimized prostheses should be introduced into clinical practice for large venous substitution. Thereafter, an adjunctive av-fistula as protection is probably no longer necessary.
Kogel
H
H
Department of Vascular, Thoracic and Cardiac Surgery, University of Ulm, Germany.
Vollmar
J F
JF
Proschek
P
P
D000818:Animals; D001807:Blood Vessel Prosthesis; D004285:Dogs; D004730:Endothelium, Vascular / Q000254:growth & development / Q000648:ultrastructure; D011138:Polytetrafluoroethylene; D011140:Polyurethanes; D014682:Vena Cava, Inferior / Q000601:surgery*
D011140:Polyurethanes; D011138:Polytetrafluoroethylene