Matched elastic properties and successful arterial grafting

Abstract

Clinical results from medium- and small-caliber arterial bypass grafts are unsatisfactory. Since elastic properties of grafts tested experimentally have been correlated with patency results, the compliance of the human femoral artery was compared with grafts currently in use: human saphenous vein (HSV), knitted Dacron (DAC), glutaraldehyde-treated umbilical cord vein (DBM), bovine heterograft, and expanded polytetrafluoroethylene (PTFE). This was correlated with clinical patency data for the different conduits in the femoropopliteal position. Increased patency correlated with a decreasing disparity between host artery and graft compliance. After two years, patency rates of the more compliant materials (HSV, DBM) exceeded 80%, while less than 45% of the incompliant grafts (DAC, PTFE) remained patent. Thus, clinical performance with synthetic grafts might be improved by use of prostheses in which the viscoelastic characteristics match those of arteries more closely.