The influence of collagen and albumen presealants on knitted Dacron grafts.
Dacron arterial grafts may be sealed with collagen or albumen to avoid preclotting. The influence on graft thrombogenicity and maturation was studied in 36 patients undergoing elective arterial bypass surgery for aortoiliac disease randomised to (i) collagen impregnated (Meadox Hemashield), (ii) albumen coated (USCI) or (iii) standard knitted Dacron (Meadox Microvel, UCSI Vasculour II) preclotted with the patient's own blood. Five days and 2 months postoperatively, autologous 111indium-labelled platelet deposition was measured as the daily increase in the ratio of graft to blood radioactivity and expressed as the Thrombogenicity Index (TI) (units, 10(-3). Duplex Doppler examination was used to detect thrombus, neointima or perigraft fluid. TI (median and interquartile range) was similar in the grafts at 5 days at 2.12 (-0.026-3.67) for preclotted Dacron, 2.72 (1.69-7.15) for collagen impregnated and 2.7 (2.13-8.56) for albumen coated Dacron, and was not significantly different at 2 months at 2.66 (2.07-5.18) (n = 9), 4.22 (1.3-7.02) (n = 8) and 2.89 (1.03-16.5) (n = 7), respectively. Duplex Doppler demonstrated perigraft fluid at the proximal anastomosis of an occluded albumen coated graft but no further abnormalities were detected. On these data sealing of knitted Dacron with collagen or albumen does not influence early graft thrombogenicity or maturation.
Department of Surgery, Charing Cross Hospital, London, U.K.
P E
PE
Bearn
C N
CN
McCollum
R M
RM
Greenhalgh
D000368:Aged; D000418:Albumins; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D001783:Blood Flow Velocity / Q000502:physiology; D001807:Blood Vessel Prosthesis; D003094:Collagen; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D007205:Indium Radioisotopes; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000502:physiology; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013499:Surface Properties
D000418:Albumins; D007205:Indium Radioisotopes; D011093:Polyethylene Terephthalates; D003094:Collagen