Modified prosthetic vascular conduits.
Atherosclerosis in the form of peripheral arterial disease results in significant morbidity. Surgical treatment options for peripheral arterial disease include angioplasty, endarterectomy, and bypass grafting. For bypass grafting, vein remains the conduit of choice; however, poor quality and limited availability have led to the use of prosthetic materials. Unfortunately, because of a lack of endothelium and compliance mismatch, neointimal hyperplasia develops aggressively, resulting in high failure rates. To improve graft patency, investigators have developed surgical, chemical, and biological graft modifications. This review describes common prosthetic materials, as well as approaches currently in use and under investigation to modify and improve prosthetic conduits for bypass grafting in an effort to improve graft patency rates.
Kapadia
Muneera R
MR
Northwestern University Feinberg School of Medicine, Division of Vascular Surgery, Chicago, IL 60611, USA.
Popowich
Daniel A
DA
Kibbe
Melina R
MR
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage; D001672:Biocompatible Materials; D001807:Blood Vessel Prosthesis / Q000639:trends; D019917:Blood Vessel Prosthesis Implantation; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D020099:Coated Materials, Biocompatible; D004343:Drug Implants; D042783:Endothelial Cells / Q000637:transplantation; D004867:Equipment Design; D004868:Equipment Failure; D006083:Graft Occlusion, Vascular / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D020030:Nitric Oxide Donors / Q000008:administration & dosage; D011138:Polytetrafluoroethylene; D011140:Polyurethanes; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D014182:Transplantation, Autologous
D000925:Anticoagulants; D001672:Biocompatible Materials; D020099:Coated Materials, Biocompatible; D004343:Drug Implants; D020030:Nitric Oxide Donors; D011140:Polyurethanes; C528226:thoralon; D011138:Polytetrafluoroethylene