Longitudinal ruptures of polyester knitted vascular prostheses.
OBJECTIVE
The purpose of the study was the characterization of a type of rupture occurring on warp-knitted polyester vascular prostheses.


METHODS
We studied 20 cases of warp-knitted polyester vascular prostheses that were explanted from humans that showed a longitudinal rupture as a part of a collaborative retrieval program. All the prostheses were immediately fixed in a 10% formaldehyde solution after their explantation in the operating room. The clinical data of these cases were recorded. The explants were photographed, washed to eliminate the surrounding tissues, and photographed again. The ruptures were characterized with macroscopic examination, optical stereomicroscopy, and scanning electron microscopy.


RESULTS
The mean duration of implantation of the prostheses was 16.0 +/- 3.3 years (range, 9-20.7 years). The prostheses were Cooley Double Velour (n = 15) and Microvel Double Velour (n = 5). There were 16 aortobifemoral bypass grafts, 1 aorto-biiliac, 1 aorto-aortic, 1 iliofemoral, and 1 axillobifemoral. The longitudinal ruptures occurred on two specific parts of the prostheses: the guide line (6 cases) and the remeshing line (11 cases). In three cases both lines were affected. Scanning electron microscopy showed major degradation of the trilobar filaments of the velour and gradual ruptures of the flat filaments of the remeshing and guide lines.


CONCLUSIONS
In this study, we have identified a specific mechanism of late (9-20 years) longitudinal rupture of knitted polyester prostheses consisting of degradation of the polyester filaments along the remeshing and guide lines that run the length of the graft.
Chakfe
N
N
Department of Cardio-Vascular Surgery, Les Hôpitaux Universitaires de Strasbourg, France.
Riepe
G
G
Dieval
F
F
Le Magnen
J F
JF
Wang
L
L
Urban
E
E
Beaufigeau
M
M
Durand
B
B
Imig
H
H
Kretz
J G
JG
D001012:Aorta, Abdominal / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008855:Microscopy, Electron, Scanning; D011091:Polyesters; D011475:Prosthesis Failure; D013997:Time Factors
D011091:Polyesters; C020542:velour