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Current and future vascular grafts 

Current and future vascular grafts
Chapter:
Current and future vascular grafts
Author(s):

Mital Desai

and George Hamilton

DOI:
10.1093/med/9780199658220.003.0011
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date: 18 September 2019

Polyethylene terephthalate (Dacron) and expanded polytetrafluoroethylene (ePTFE) grafts have been very successful in replacing medium and large diameter vessels. However, as graft diameter decreases below 6 mm, the performance has been consistently poor. Autologous vein remains the conduit of choice for infrageniculate bypasses. However, almost a third of patients do not have a suitable available vein due to varicose veins, previous removal, bypass or phlebitis, fibrosis or trauma, or if the vein is too small. In these patients, prosthetic grafts are required. Prosthetic materials have a tendency to fail due to thrombosis and insufficient healing with incomplete endothelial cell coverage. Compliance mismatch and haemodynamic imbalance are further factors leading to intimal hyperplasia (IH) one of the fundamental causes of graft occlusion.

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