TY - JOUR
T1 - Dilatation of aortic grafts over time: what to expect and when to be concerned
AU - Schroeder, Torben V
AU - Eldrup, Nikolaj
AU - Just, Sven
AU - Hansen, Marc
AU - Nyhuus, Bo
AU - Sillesen, Henrik
N1 - Keywords: Aged; Aortic Aneurysm; Aortic Diseases; Aortography; Arterial Occlusive Diseases; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Female; Humans; Male; Middle Aged; Polyesters; Polytetrafluoroethylene; Prospective Studies; Prosthesis Design; Prosthesis Failure; Time Factors; Tomography, X-Ray Computed; Treatment Failure
PY - 2009
Y1 - 2009
N2 - Dilatation of aortic prosthetic grafts is commonly reported, but most reports are anecdotal, with little objective data in the literature. We performed a prospective trial of 303 patients who underwent prosthetic graft repair for aortic aneurysm or occlusive disease, randomizing patients between insertion of a woven polyester or expanded polytetrafluoroethylene (ePTFE) graft. Patients were followed with computed tomography and ultrasonography for up to 5 years in order to assess the frequency and magnitude of postoperative dilatation. Graft dilatation was documented in patients with polyester grafts at 12 months. Thereafter and up to 60 months, polyester grafts did not dilate further. After 5 years, polyester prostheses had dilated by 25% and ePTFE by 12.5%, as determined by computed tomography imaging. These observations suggest that dilatation of prosthetic grafts is more frequent with knitted polyester grafts compared with ePTFE. Dilatation occurs within the first year after implantation and can be, in part, explained by a discrepancy between the initial nominal graft diameter and its diameter after clamp release, probably due to an in vivo adaptation of the textile structure. Interestingly, graft dilatation did not appear to be associated with an increased frequency of graft-related complications.
AB - Dilatation of aortic prosthetic grafts is commonly reported, but most reports are anecdotal, with little objective data in the literature. We performed a prospective trial of 303 patients who underwent prosthetic graft repair for aortic aneurysm or occlusive disease, randomizing patients between insertion of a woven polyester or expanded polytetrafluoroethylene (ePTFE) graft. Patients were followed with computed tomography and ultrasonography for up to 5 years in order to assess the frequency and magnitude of postoperative dilatation. Graft dilatation was documented in patients with polyester grafts at 12 months. Thereafter and up to 60 months, polyester grafts did not dilate further. After 5 years, polyester prostheses had dilated by 25% and ePTFE by 12.5%, as determined by computed tomography imaging. These observations suggest that dilatation of prosthetic grafts is more frequent with knitted polyester grafts compared with ePTFE. Dilatation occurs within the first year after implantation and can be, in part, explained by a discrepancy between the initial nominal graft diameter and its diameter after clamp release, probably due to an in vivo adaptation of the textile structure. Interestingly, graft dilatation did not appear to be associated with an increased frequency of graft-related complications.
U2 - 10.1053/j.semvascsurg.2009.04.002
DO - 10.1053/j.semvascsurg.2009.04.002
M3 - Journal article
C2 - 19573752
SN - 0895-7967
VL - 22
SP - 119
EP - 124
JO - Seminars in Vascular Surgery
JF - Seminars in Vascular Surgery
IS - 2
ER -