Collagen versus gelatin-coated Dacron versus stretch polytetrafluoroethylene in abdominal aortic bifurcation graft surgery: results of a seven-year prospective, randomized multicenter trial.
BACKGROUND
A prospective randomized multicenter trial was performed to compare knitted gelatin-coated Dacron bifurcation grafts, knitted collagen-coated Dacron grafts, and stretch polytetrafluoroethylene (PTFE) grafts.


METHODS
Between 1991 and 1998, 315 elective patients were randomized by age, gender, diabetes, runoff, indication (aneurysm, aortoiliac occlusive disease), and nicotine consumption at 3 centers of vascular surgery in Austria. The patients received gelatin-coated Dacron (GEL-D) grafts (n = 109), collagen-coated Dacron (COL-D) grafts (n = 100), or stretch PTFE grafts (n = 106).


RESULTS
No intraoperative deaths occurred. The 30-day mortality was 3%. No difference was found between the 3 graft materials in long-term patency. The primary 5-year patency rates were 92% for GEL-D, 89% for COL-D, and 91% for stretch PTFE (P =.6001). The secondary 5-year patency rates also differed: 97% for GEL-D, 100% for COL-D, and 97% for stretch PTFE (P =.2062). Early occlusions were observed overall in 3% and late occlusions in 5% of patients. When both Dacron grafts were compared collectively with stretch PTFE, a difference was found in infection rate: Dacron 3% (6/209) versus PTFE 0% (0/106); P <.03.


CONCLUSIONS
The bifurcation grafts of all 3 materials were comparable in primary and secondary patency rates, incidence of false aneurysms, and rate of perioperative complications. Graft infections were confined to the 2 Dacron grafts and did not occur in stretch PTFE grafts.
Prager
M
M
Department of Vascular Surgery, University of Vienna Medical School, Vienna, Austria.
Polterauer
P
P
Böhmig
H J
HJ
Wagner
O
O
Fügl
A
A
Kretschmer
G
G
Plohner
M
M
Nanobashvili
J
J
Huk
I
I
D001012:Aorta, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D020099:Coated Materials, Biocompatible; D003094:Collagen; D005260:Female; D005780:Gelatin; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D016019:Survival Analysis; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality
D020099:Coated Materials, Biocompatible; D011093:Polyethylene Terephthalates; D005780:Gelatin; D011138:Polytetrafluoroethylene; D003094:Collagen