A Prospective Randomized Study of Three Expanded Po lytetrafluoroethylene (PTFE) Grafts as Small Arterial Substitutes OTIS M. HASTINGS, M.D., KRISHNA M. JAIN, M.D., ROBERT W. HOBSON, 11, M.D., KENNETH G. SWAN, M.D.

A prospective, double-blind, randomized study was performed to determine the relative patency rate of polytetrafluoroethylene (PTFE) grafts, Gore-Tex,® Impra,® and a Surgikosg prototype PTFE graft. The 48 grafts (40 x 4 mm) replaced excised segments of femoral arteries in adult mongrel dogs, whose mean weight was 20.6 + 0.9 kg; the grafts were removed after 12 weeks. Sterile technique and antibiotic therapy were included in the study. Anticoagulation was not employed. Anastomoses were performed with 6 = 0 polypropylene. Angiographic assessment of each anastomosis was made at surgery and prior to sacrifice. Patency was assessed daily by palpation and Doppler flow signals, as well as angiographically, prior to sacrifice. The overall patency rate was 62.5%. There were no statistically significant differences in patency rates among the three groups (Gore-Tex, 56%; Impra, 75%; Surgikos, 56%). Histologic evaluation revealed incomplete neointima formation and significant pannus formation in all three types of grafts without any significant discernible difference among them. The results suggest that further experimental evaluation of PTFE, as a small vessel substitute, is indicated prior to its use clinically in preference to autogenous vein. E XPANDED POLYTETRAFLUOROETHYLENE

(PTFE)

was studied by Soyer9 in 1972 as a large vein replacement in the piglet, with good results. The material was quickly adopted for study as a small arterial substitute. Matsumotu5 reported an impressive patency of 100%, in a large series of dogs, using the graft as a femoral arterial implant. Unfortunately, the follow-up period varied and the details of the structural characteristics of the graft were not discussed in the report. In addition, nonporous Teflon® prostheses were used as controls and all of them were occluded between seven and 110 days postimplantation. Presented in part at the Fourth Annual Peripheral Vascular Surgery Seminar of the Society of Military Vascular Surgeons, Walter Reed Army Medical Center, Washington, D.C., December 1976.

Reprint requests: Kenneth G. Swan, M.D., Professor of Surgery, CMDNJ, New Jersey Medical School, 100 Bergen Street, Newark, New Jersey 07103. Submitted for publication: May 22, 1978.

From the Department of Surgery, College of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey.

Campbell2 compared graft fibril length and patency of prostheses placed in canine femoral arteries. He observed greater patency (88%) with relatively short (

A prospective randomized study of three expanded polytetrafluoroethylene (PTFE) grafts as small arterial substitutes.

A Prospective Randomized Study of Three Expanded Po lytetrafluoroethylene (PTFE) Grafts as Small Arterial Substitutes OTIS M. HASTINGS, M.D., KRISHNA...
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