title: Electron microscopy study of a vascular prosthesis destructed in vivo reveals fractures in Dacron fibers.
abstract: The genuine destruction of a synthetic prosthesis wall, as a late complication of vascular surgery, is extremely rare. We report a case of a 64-year-old male who had his 12-year-old femoropopliteal synthetic graft explanted due to two large pseudoaneurysms in the middle section of the graft. Microscopic evaluation demonstrated the areas of focal thinning along the entire prosthesis wall, with "foreign body" type reaction in the adjacent connective tissue. Transmission electron microscopy showed longitudinal fractures of Dacron fibers interposed with cellular structures, suggesting that destruction must have taken place significantly earlier. The problems of limited graft durability and graft surveillance are discussed.
authors.affiliation: Department of General and Vascular Surgery, Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Poland drww@onet.pl.
authors.forename: Witold
authors.initials: W
authors.lastname: Woźniak
authors.affiliation: Department of Pathology, Maria Sklodowska-Curie Cancer Center, Warsaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Olszewski
authors.affiliation: Department of General and Vascular Surgery, Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Górski
mesh_terms: D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D020878:Device Removal; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000601:surgery*; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D011093:Polyethylene Terephthalates
keywords: Blood vessel prosthesis; degradation; polyester; rupture; vascular grafts