Expanded polytetrafluoroethylene arterial prostheses in humans: chemical analysis of 79 explanted specimens.
The expanded polytetrafluoroethylene (ePTFE) vascular prostheses are widely used as small and medium diameter blood conduits when an autologous venous material is not available or is not suitable. The long-term performance of a prosthesis is dependent on several factors, including its healing characteristics and its stability in vivo. This study was undertaken to assess whether chemical degradation of ePTFE occurs when such arterial substitutes are implanted in humans. Seventy-nine ePTFE grafts excised for complications were analysed using the following techniques: measurement of the contact angle (theta), electron spectroscopy for chemical analysis (ESCA or XPS), Fourier transform infra-red spectroscopy (FTIR) and differential scanning calorimetry (DSC). The results were compared with those obtained from virgin ePTFE and virgin ePTFE washed prostheses. The measurement of the contact angle (theta) permits the comparison of the level of hydrophobicity of material after in vivo residency. The contact angles of explanted ePTFE grafts are greater than those of virgin ones but remain close to those of washed virgin prostheses. The ESCA method allowed investigation of the chemical changes which occur on the surface of ePTFE prostheses after implantation because of the low penetration of the X-ray (about 50 A). This study did not reveal any chemical degradation of the ePTFE with time of implantation for periods up to 6.5 yr. Changes in the surface composition were probably related to lipid and/or protein uptake. The FTIR spectroscopy provides information about the chemical composition of material. Compared with the virgin ePTFE prostheses, the FTIR spectra of explanted prostheses showed specific bands which are characteristic of lipid and/or protein absorptions. The bulk properties of ePTFE studied by DSC did not show any significant changes with time of implantation. It is concluded that ePTFE grafts remain stable in vivo for periods up to 6.5 yr.
Department of Surgery, Laval University, Québec, Canada.
R
R
Guidoin
S
S
Maurel
N
N
Chakfé
T
T
How
Z
Z
Zhang
M
M
Therrien
M
M
Formichi
C
C
Gosselin
D001672:Biocompatible Materials / Q000009:adverse effects; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002152:Calorimetry, Differential Scanning; D004577:Electron Probe Microanalysis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008855:Microscopy, Electron, Scanning; D011138:Polytetrafluoroethylene / Q000009:adverse effects / Q000737:chemistry; D017550:Spectroscopy, Fourier Transform Infrared
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene