Longitudinal ruptures of polyester knitted vascular prostheses.

AIM The purpose of the study was the characterization of a type of rupture occurring on warp-knitted polyester vascular prostheses. MATERIALS AND 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.

[1]  Nunn Db.  Structural failure of Dacron arterial grafts. , 1999 .

[2]  S. Wilson,et al.  Late Disruption of Dacron Aortic Grafts , 1997, Annals of vascular surgery.

[3]  E. Schneider,et al.  Long-term in vivo alterations of polyester vascular grafts in humans. , 1997, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[4]  M. V. Vrancken Peeters,et al.  Late rupture of femoropopliteal Dacron grafts: a rare complication. , 1996, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[5]  J. Stanley,et al.  Current Therapy in Vascular Surgery , 1991 .

[6]  B. Pourdeyhimi,et al.  On the correlation between the failure of vascular grafts and their structural and material properties: a critical analysis. , 1986, Journal of biomedical materials research.

[7]  K. Gunasekera,et al.  Degradation of Polyester Arterial Prostheses: A Physical or Chemical Mechanism? , 1985 .

[8]  W. Gryboski,et al.  Aneurysms of a double velour aortic graft. , 1984, Archives of surgery.

[9]  T. Watanabe,et al.  Failure of dacron arterial prostheses caused by structural defects. , 1983, The Journal of cardiovascular surgery.

[10]  L. Sauvage,et al.  Late fiber deterioration in Dacron arterial grafts. , 1981, Annals of surgery.

[11]  Lynn Rb.  Knitted Dacron ultra-lightweight grafts--a warning. , 1979 .

[12]  M. H. Freeman,et al.  Postoperative Alterations in Size of Dacron Aortic Grafts: An Ultrasonic Evaluation , 1979, Annals of surgery.

[13]  M. Richman,et al.  Failure of Dacron prostheses caused by structural defect. , 1978, Surgery.

[14]  R. Blumenberg,et al.  Failure of knitted dacron as an arterial prosthesis. , 1977, Surgery.

[15]  H. Hussey.  Arterial Replacement: Failure of Synthetic Prostheses , 1976 .

[16]  Hussey Hh.  Editorial: Arterial replacement: failure of synthetic prostheses. , 1976 .

[17]  R. Darling,et al.  Failure of ultralightweight knitted Dacron grafts in arterial reconstruction. , 1976, Archives of surgery.

[18]  R. Stoney,et al.  Dacron aortic graft failure. , 1974, Archives of surgery.

[19]  M. Orringer,et al.  An unusual complication of axillofemoral artery bypass. , 1972, Surgery.