Preliminary Clinical Experience with Polyurethane Vascular Prostheses in Femorodistal Reconstruction

Abstract

After promising results in animal experimentation, implantation of polyurethane vascular prostheses for femoral reconstruction was performed in 15 patients during a 10-month period. This prospective study was carried out to evaluate patency, limb salvage and complications associated with this type of small diameter conduit for arterial occlusive diseases. Indications for operation included acute and chronic ischemia, nonhealing ulceration, or gangrene. They were five early occlusions, which resulted in a 1-month primary patency rate of 66% and a secondary patency rate of 80%. The mean limb salvage rate at one month was 80% and at this stage of the study, 66%. Infection occurred in one patient following multiple graft thrombectomy attempts. There were no statistically significant differences in patency rates between proximal and distal popliteal graft anastomoses. Two critical phases of healing, in which the graft was prone to flow deterioration, were identified at 4 to 6 weeks and at 4 to 6 months. Electron microscopic studies revealed early endothelial cell formation even under poor hemodynamic conditions, minimal graft-host reaction and good structural resistance at the suture site. Further intensive investigations, however, are required to identify patient groups who would benefit from such a prosthesis.