The mechanical properties of infrainguinal vascular bypass grafts: their role in influencing patency.
When autologous vein is unavailable, prosthetic graft materials, particularly expanded polytetrafluoroethylene are used for peripheral arterial revascularisation. Poor long term patency of prosthetic materials is due to distal anastomotic intimal hyperplasia. Intimal hyperplasia is directly linked to shear stress abnormalities at the vessel wall. Compliance and calibre mismatch between native vessel and graft, as well as anastomotic line stress concentration contribute towards unnatural wall shear stress. High porosity reduces graft compliance by causing fibrovascular infiltration, whereas low porosity discourages the development of an endothelial lining and hence effective antithrombogenicity. Therefore, consideration of mechanical properties is necessary in graft development. Current research into synthetic vascular grafts concentrates on simulating the mechanical properties of native arteries and tissue engineering aims to construct a new biological arterial conduit.
Sarkar
S
S
Academic Division of Surgical and Interventional Sciences, Biomaterials and Tissue Engineering Centre (BTEC), University College London, London, UK.
Salacinski
H J
HJ
Hamilton
G
G
Seifalian
A M
AM
D000714:Anastomosis, Surgical; D000818:Animals; D001158:Arteries / Q000473:pathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D001783:Blood Flow Velocity; D001807:Blood Vessel Prosthesis; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006801:Humans; D006965:Hyperplasia; D035002:Lower Extremity / Q000098:blood supply*; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011140:Polyurethanes; D011312:Pressure; D011474:Prosthesis Design; D011673:Pulsatile Flow; D023822:Tissue Engineering; D017539:Tunica Intima / Q000473:pathology; D014654:Vascular Patency
D011093:Polyethylene Terephthalates; D011140:Polyurethanes; D011138:Polytetrafluoroethylene