A brief review of the textile structures employed in the construction of vascular grafts is followed by a survey of the causes of failure cited in the literature. An attempt is made to determine the structural factors contributing to the failure of vascular grafts, and attention is given to material properties and methods for determining these attributes. Need for further research is emphasized.
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References
1.
Voorhees, A.B. , A. Jaretski and A.H. Blakemore. "The Use of Tubes Constructed from Vinyon 'N' Cloth in Bridging Arterial Defects," Ann. Surg. , 135:332-336 (1952).
2.
Callow, A.D. "Historical Development of Vascular Grafts" in Vascular Grafts. P. N. Sawyer and M. J. Kaplitt, eds. New York: Appleton-Century Crafts, pp. 5-22 (1977).
3.
Voorhees, A.B. "How It All Began," in Vascular Grafts. P. N. Sawyer and M. J. Kaplitt , eds. New York:Appleton-Century Crafts, pp. 3-4 (1977).
4.
Creech, O., R.A. Deterling and S. Edwards. "Vascular Prostheses: Report of the Committee for the Study of Vascular Prostheses of the Society of Vascular Surgery," Surgery, 41:62-73 (1957).
5.
Sgilagyi, D.E. "Perspectives in Vascular Grafting," in Vascular Grafts.P. N. Sawyer and M. J. Kaplitt, eds. New York:Appleton-Century Crafts, pp. 23-26 (1977).
6.
King, M., P. Blais, R. Guidion et al. "Polyethylene Terephthalate (Dacron) Vascular Prostheses: Material and Fabric Construction Aspects," in Biocompatibility of Clinical Implant Materials. D.F. Williams, ed. 2, pp. 190-206 (1970).
7.
Sauvage, L.R., K. Berger and A. B. Barros D'sa . "Dacron Arterial Prostheses" in Graft Materials in Vascular Surgery. H. Dardik , ed. Chicago:Yearbook Med. Publ ., pp. 153-169 (1978).
8.
Creech, O., R.A. Deterling and S. Edwards. "Vascular Prostheses: Report of the Committee for the State of Vascular Prostheses of the Society for Vascular Surgery," Surgery, 41:62-80 (1957).
9.
Sidebotham, J. B. U.S.P. 2,845,959 (Aug., 1958).
10.
Biebig, W. J. U.S.P. 2,978,787 (Apr., 1961).
11.
Liebig, W. J. U.S.P. 3,096,560 (July, 1963).
12.
Scott, S.M. "A Woven Double Velour Dacron Vascular Graft" Presented at the 8th Annual Meeting of the Society of Biomaterials, Anaheim, California, April 24-27, 1982.
13.
Pourdeyhimi, B. and S. Kern. "Ease of Suturing in Surgical Fabrics: A Quantitative Evaluation," Am. J. Surg., 149:387-391 (1985).
14.
Sauvage, L. R. U.S.P. 3,878,565 (April 22, 1975).
15.
Sauvage, L.R. , K. Berger, P.B. Mansfield and S.J. Wood. "Future Directions in the Development of Arterial Prostheses for Small and Medium Caliber Arteries ," Surg. Clin. N. Am., 54:213-228 (1974).
16.
Sauvage, L.R. , K. Berger, S.J. Wood and S.G. Yates. "Interspecies Healing of Porous Arterial Prostheses: Observations, 1960-1974," Arch. Surg., 109:698-705 (1974).
17.
Sauvage, L.R. , K. Berger, L.B. Beilin and J.C. Smith. "Presence of Endothelium in an Axillary Femoral Graft of Knitted Dacron with an External Velour Surface," Ann. Surg., 182:749-753 (1975).
18.
Wesolowski, S.A.Evaluation of Tissue and Prosthetic Vascular Grafts, Vol. 3. Springfield :Thomas (1962).
Soyer, T., M. Lempinen and P. Cooper. "A New Venous Prosthesis," Surgery, 72:864-869 (1972).
24.
Okita, K. U.S.P. 4,208,745 (June, 1980).
25.
Mano, H. U.S.P. 4,321,711 (Mar., 1982).
26.
Mano, H. U.S.P. 4,304,010 (Dec., 1981).
27.
Mano, H. U.S.P. 4,306,318 (Dec., 1981).
28.
U.S.S.R. Patent 562,278 (Sept., 1977).
29.
Enger, E. U.S.P. 4,011,861 (Mar., 1977).
30.
McClurken, M.E., J.M. McHaney and W.M. Colone. "Physical Properties and Test Methods for Expanded Polytetrafluoroethylene (PTFE) Grafts;' in Vascular Graft Update: Safety and Performance , ASTM STP 898, Philadelphia:American Society for Testing and Materials, pp. 82-94 (1986).
31.
LeVeen, M.H. and J.R. Barberio. "Tissue Reactions to Plastics Used in Surgery with Special Reference to Teflon," Ann. Surg., 129:74-79 (1949).
32.
Sawyer, P.N. , B. Stawzewski, R. Turner and H. Hoffman. "Evaluation of Chemical Compacting Techniques on the Performance, Thrombosis Rate, Histology and Healing of Experimental Similarly Fabricated Dacron Prostheses" Trans. Am. Soc Artif. Intern. Organs, 24:215-224 (1978).
33.
Tapp, J. S. U.S.P. 2,836,181 (May, 1958).
34.
Roberts, R. E. U.S.P. 3,076,737 (Feb., 1963).
35.
Starks, E. E. U.S.P. 3,029,819 (Apr., 1962).
36.
Pourdeyhimi, B. "Vascular Grafts: Textile Structures and Their Performance," Textile Progress, 15(3) (1987).
37.
Newton, W.J. , J.M. Stokes and H.R. Butcher. "Changes in the Elasticity of Arterial Substitutes Following Implantation," Surgery, 46:579-587 (1959).
38.
Hamlin, G.W. , F.M. Rajah, M.J. Crow and R.C. Kester. "Evaluation of the Thrombogenic Potential of Three Types of Arterial Graft Studies in an Artificial Circulation," Br. J. Surg., 65:272-276 (1978).
39.
Takebyashi, J., M. Kamatani, S. Namba and Y. Katagami. "Early Reparative Process of Implanted Arterial Prostheses: A Morphological and Hematological Study;' J. Surg. Res., 17:102-110 (1974).
40.
Herring, M. , R. Dilley, A. Gardner and J. Glover. "The Effects of Crimping on the Healing of Prosthetic Arterial Grafts" J. Cardiovas. Surg., 21:596-603 (1980).
41.
Takebayashi, J., M. Kamatani and Y. Katagami. "A Comparative Study on the Potency of Crimped and Noncrimped Vascular Prostheses, with Emphasis on the Earliest Morphological Changes," J. Surg. Res., 19:209-218 (1975).
42.
Kenney, D.A. , L.R. Sauvage and S.J. Wood. "Comparison of Noncrimped, Externally Supported (EXS) and Crimped Dacron Prostheses," Surgery, 92:931-946 (1982).
43.
Schmitt, E. E. and R. A. Polistina. U.S.P. 3,463,158 (Aug., 1969).
Bowald, S., C. Busch and I. Eriksson. "Absorbable Materials in Vascular Prostheses: A New Device ;' Acta. Chir. Scand., 146:391-396 (1981).
46.
Whillsey, R.H. , N.M. Sekerak and J.W. Blunt. "Observations of Elastic Synthetic Sleeves as Vascular Prostheses;' Arch. Surg., 93:440-446 (1956).
47.
Corbiere, P J. U.S.P. 3,011,527 (Dec., 1961).
48.
Szilagyi, D.E. , L.C. France and R.F. Smith. "The Clinical Use of an Elastic Dacron Prosthesis," Arch. Surg., 77:538-541 (1958).
49.
Szilagyi, D.E., R.F. Smith, J.P. Elliot and H.M. Allen. "Long Term Behavior of a Dacron Arterial Substitute." Presented before the Amer. Surg. Assoc, May 12-14, Philadelphia, Pennsylvania, 1969.
50.
Wagner, M., G. Reul and J. Teresi. "Experimental Observations on a New and Inherently Elastic Material for Sutures and Vascular Prostheses: Lycra;' Amer. J. Surg. , 111:838-840 (1966).
51.
Wagner, M., G. Reul and J. Teresi. "The Use of Spandex as a Vascular Patch Graft Material," Surg., Gynec. Obst., 127:805-808 (1968).
52.
Guidoin, R. , C. Gosselin, D. Domurado and M. Marois. "Dacron as Arterial Prosthetic Material: Nature, Properties, Brands, Fate and Perspectives" Biomat., Med. Dev., Art. Org., 5:177-203 (1977).
53.
Rosenberg, N. "Physiological Factors in Arterial Grafting " in Graft Materials in Vascular Surgery. H. Dardik, ed. Miami: Symposia Specialists, pp. 15-28 (1978).
54.
Rosenberg, N., A.N. Simpson and R.E. Brown. "A Circumferentially Elastic Arterial Prosthesis: Three Year Studies of a Dacron-Spandex Graft in the Dog;' J. Surg. Resl, 34:7-16 (1983).
55.
Leidner, J. , E.W.C. Wong, D.C. MacGregor and G.J. Wilson. "A Novel Process for the Manufacturing of Porous Grafts: Process Description and Product Evaluation ;' J. Biomed. Mat. Res., 17:229-247 (1983).
56.
Lightwood, R. U.S.P. 3,490,975 (Jan., 1970).
57.
Wesolowski, S.A., C.C. Fries, K.E. Karlson, M.E. DeBakey and P.N. Sawyer. "Porosity: Primary Determinant of Ultimate Fate of Synthetic Vascular Grafts," Surgery, 50:91-98 (1961).
Chang, T.M.S. "Removal of Endogenous and Exogenous Toxins by a Microencapsulated Absorbent;' Can. J. Physiol. Pharm. , 47:1043-1045 (1969).
60.
Kim, S.W., R.G. Lee, H. Oster, D. Coleman, J.D. Antrade, D.J. Lentz and D. Olsen. "Platelet Adhesion to Polymer Surfaces;' Trans. Am. Soc. Artif. Int. Org., 20:449-455 (1974).
61.
Kim, S.W., R.G. Lee, M. Oster, D. Coleman, J.D. Antrade, D.J. Lentz and D. Olsen. "Platelet Adhesion to Polymer Surfaces;' Trans. Am. Soc. Artif. Int. Org., 20:449-455 (1974).
62.
Lyman, D.J. , L.C. Metcalf, J.D. Albo, R.F. Richards and J. Lamb. "The Effect of Chemical Structure and Surface Properties of Synthetic Polymers on the Coagulation of Blood: III. In vivo Absorption of Proteins on Polymer Surfaces," Trans. Am. Soc. Artif. Int. Org., 20:474-478 (1974).
63.
Domurado, D. , D. Thomas andG. Brown. "A New Method for Producing Protein Coatings " J. Biomed. Mater. Res., 9:109-110 (1975).
64.
Brown, G., C.T. Minh, D. Thomas, D. Domurado and E. Selegny. "The Use of Proteic and Enzymatic Coatings and/or Membranes for Oxygenators" Trans. Am. Soc. Artif. Int. Org., 17:341-349 (1971).
65.
Thomas, D. and G. Brown. "Some Aspects of the Regulation and Transport in Enzyme Membrane Models;' Biochimie, 55:975-984 (1973).
66.
Guidoin, R.G. , J.A. Award and A. Bassard. "Antithrombogenicity of Poly-proteic Membranes In vivo Evaluation: A Preliminary Report;' Biomator. Med Dev. Artif. Org., 2:301-306 (1974).
67.
Kurtz, L. D. U.S.P. 3,688,317 (Sept., 1972).
68.
Hufnagel, C.A. , P.W. Conrad and J.F. Gillespie. "Comparative Studies of Cardiac and Vascular Implants in Relation to Thrombosis;' Surgery, 61: 11-16(1967).
69.
Gott, V.L., J.D. Whiffen and R.C. Dutton. "Heparin Bonding on Colloidal Graphite Surfaces;' Science, 142:1297-1298 (1965).
70.
Whiffen, J.D. , R.C. Dutton, W.P. Young and V.L. Gott. "Heparin Application to Graphite Coated Intravascular Prosthesis;' Surgery, 56:404-412 (1964).
71.
Gott, Y.L., J.D. Whiffen and D.E. Koepke. "Techniques for Applying a Graphite-Benzalkanium-Heparin Coating to Various Plastics and Metals," Trans. Am. Soc. Artif. Int. Org., 10:213-217 (1964).
72.
Sharp, W.V. , D.L. Gardner and G.J. Anderson. "A Bioelectric Polyurethane Elastomer for Intravascular Replacement," Trans. Am. Soc. Artif. Int. Org., 12:179-182 (1966).
73.
Sharp, W.V. , D.L. Gardner, G.J. Anderson and J.I. Wright. "Electrolour: A New Vascular Interface ;' Trans. Am. Soc. Artif. Int. Org., 14:73-77 (1968).
74.
Sharp, W.V. , B.C. Taylor, J.I. Wright and A.F. Finelli. "Experience with Negatively Charged Polyurethane-Backed Velours," J. Biomed. Mater. Res. Symp., 1:75-81 (1971).
75.
Taylor, B.C. , W.V. Sharp andJ.I. Wright. "The Importance of Zeta Potential Ultrastructure, and Electrical Conductivity to the In vivo Performance of Polyurethane-Carbon Black Vascular Prostheses," Trans. Am. Soc. Artif. Int. Org. , 17:22-26 (1971).
76.
Miller, B.G. , K.A. Dyer and B.C. Taylor. "Electrical Conductivity: Effect on Intravascular Performance of Foams, Velour, Flock and Fabric" Trans. Am. Soc. Artif. Int. Org., 20:91-100 (1974).
77.
Adams, D., D.F. Williams and J. Hill. "Carbon Fiber-Reinforced Carbon as a Potential Implant Material;' J. Biomed. Mater. Res., 12:35-42 (1978).
78.
Haubold, A.D. and J.D. Norman. "Velva Low Temperature Isolvopically (U.L.T.I.) Deposited Carbon (Biolite): A Promising New Flexible Blood Interfacing Biomaterial; ' Cardiovasc. Dis. Bull., Texas Heart Inst., 4:369-370 (1977).
79.
Sharp, W.V. "The Carotid Artery: A Test Site for Small Vessel Prosthetics," J. Surg. Res., 10:41-46 (1970).
80.
Beall, A.C. , Jr., G.C. Morris, Jr. and J.F. Howell. "Clinical Experience with an Improved Mitral Valve Prosthesis," Ann. Thorac. Surg. , 15:601-606 (1973).
81.
Beall, A.C. , Jr., G.C. Morris, Jr. and G.P. Noon. "An Improved Mitral Valve Prosthesis;' Ann. Thorac. Surg., 15:25-34 (1973).
82.
Bokros, J. C. U.S.P. 3,526,005 (Sept., 1970).
83.
Bokros, J. C. U.S.P. 3,685,059 (Aug., 1972).
84.
Bokros, J. C. U.S.P. 3,677,795 (July, 1972).
85.
Bokros, J. C. U.S.P. 4,164,045 (Aug., 1979).
86.
Reick, F. G. U.S.P. 3,914,802 (Oct., 1975).
87.
Kronenthal, R. L. U.S.P. 3,276,488 (Oct., 1966).
88.
Ohara, I. and S. Nakano. "Rupture of Arterial Plastic Prosthesis (Anylanpolyethylene Tube),"Arch. Surg., 77:55-60 (1958).
89.
Knox, W.G. "Aneurysm Occurring in a Femoral Artery Dacron Prosthesis Five and One-Half Years After Insertion," Ann. Surg., 156:827-830 (1962).
90.
Sautt, J. "Possibilities and Limitation of Repeated Restorative Surgery in Secondary and Delayed Failure;' J. Cardiovasc. Surg., 5:481-501 (1964).
91.
Wesolowski, S.A., C.C. Fries and G. Henninger. "Factors Contributing to Long Term Failures in Human Vascular Prosthetic Grafts," J. Cardiovasc. Surg., 5:544-567 (1964).
92.
Olsen, W.R. , A.A. Mich and M.S. DeWeese. "False Aneurysm of Abdominal Aorta," Arch. Surg., 92:123-130 (1966).
93.
Martin, A. and P.W.M. Copeman. "Aortojejumal Fistula from Rupture of Teflon Graft, with Septic Emboli in the Skin;' Br. Med. J., 2:155-156 (1967).
94.
Summer, D.S. and D.E. Strandness. "False Aneurysm Occurring in Association with Thrombosed Prosthetic Grafts," Arch. Surg., 94:360-362 (1967).
Ottinger, M.B. , R.B. Rutherford and D.B. Skinner. "An Unusual Complication of Axillofemoral Bypass;' Surgery, 72:769-771 (1972).
100.
Cook, P.A. , P.A. Nobis and R.J. Stoney. "Dacron Aortic Graft Failure;' Arch. Surg., 108:101-103 (1974).
101.
Yow, P.B., T.W. Grisell and W.M. Wahle. "Fate of a Nylon Vascular Prosthesis for Aortic Replacement: 14 Year Follow-Up Study;' Surgery, 75: 140-144 (1974).
102.
Perry, O.M. "Early Failure of Dacron Prosthetic Grafts;' J. Cardiovasc. Surg., 16:318-321 (1975).
103.
Hayward, R.H. and F.L. Korompai. "Degeneration of Knitted Dacron Grafts ," Surgery, 79:581-583 (1976).
104.
Wren, H.B. "False Aneurysms of the Femoral Artery;' Ann. Surg., 183: 700-701 (1976).
105.
Ottinger, L.W. , C. Darling and L.S. Wirthlin. "Failure of Ultra-lightweight Knitted Dacron Grafts in Arterial Reconstruction;' Arch. Surg., 111:146-149 (1976).
106.
Rais, O., B. Lundstrom and K.A. Angquist. "Bilateral Aneurysm of Dacron Graft Following Aorta Femoral Graft Operation," Acta. Chir. Scand., 142:479-482 (1976).
107.
Campbell, C.C. , D.H. Brooks and M.W. Webster. "Aneurysm Formation in Expanded Polytetrafluoroethylene Prostheses;' Surgery, 79:491-493 (1976).
108.
Charez, C.M. "False Aneurysms of the Femoral Artery: A Challenge in Management," Ann. Surg., 183:694-700 (1976).
109.
Blemenberg, R.M. and M.L. Gelfand. "Failure of Knitted Dacron as Arterial Prosthesis;' Surgery, 81:493-496 (1977).
110.
Wesolowski, S.D.Discussion in Vascular Grafts. P. N. Sawyer and M. J. Kaplitt , eds. New York:Appleton-Century Crafts , pp. 226-230 (1978).
111.
May, J. "Multiple Aneurysms in Dacron Velour Graft," Arch. Surg., 113: 320-321 (1978).
112.
Edwards, W.S. "Arterial Grafts of Teflon" in Vascular Grafts. P. N. Sawyer and M. J. Kaplitt, eds. New York: Appleton-Century Crafts, pp. 173-176 (1978).
113.
Tutassuaura, H., A.N. Gerein and J.G. Sladen. "True Aneurysm in Prosthetic Femoropopliteal Grafts;' Am. Surg., 44:262-266 (1978).
114.
Roberts, A.K. and N. Johnson. "Aneurysm Formation in an Expanded Microporous Polytetrafluoroethylene Graft;' Am. Surg., 113:211-213 (1978).
115.
Yashar, J.J. , M.H. Richman and J. Dyckman. "Failure of Dacron Prostheses Caused by Structural Defect;' Surgery, 84:659-663 (1978).
116.
Nunn, D.B. , M.H. Freeman andP.C. Hodgins. "Postoperative Alterations in Size of Dacron Aortic Grafts. An Ultrasonic Evaluation;' Ann. Surg. , 189:741-744 (1979).
117.
Kim, G.E., A.M. Imparato and I. Nathan. "Dilatation of Synthetic Grafts and Junctional Aneurysms ," Arch. Surg., 114:1296-1303 (1979 ).
Kaupp, H.A. , T.J. Matulewicz and G.L. Lattimer. "Graft Infection or Graft Reaction?" Arch. Surg., 114:1419-1422 (1979).
120.
Koopman, M.D.E. and L.C. Brands. "Degenerative Changes in Dacron External Velour Vascular Prostheses: A Report of Three Cases;' J. Cardiovasc. Surg., 21:159-162 (1980).
121.
Berger, K. and L.R. Sauvage. "Late Fiber Deterioration in Dacron Arterial Graft," Ann. Surg., 4:477,491 (1981).
122.
Pourdeyhimi, B. and H.D. Wagner. "On the Correlation Between the Failure of Vascular Grafts and Their Properties: A Critical Analysis;' J. Biomed. Mater. Res., 20:375-409 (1985).
123.
Salzman, E.W. "The Events that Lead to Thrombosis," Bull. New York Acad. Med., 48:225-234 (1972).
124.
Stemerman, M.B. "Features of Vascular Healing and Thrombosis," in Graft Materials in Vascular Surgery. H. Dardik, ed. Chicago:'Yearbook Med. Publ., pp. 29-42 (1978).
125.
Leonard, E.F. "The Role of Flow in Thrombogenesis," Bull. New York Acad. Med., 48:273-280 (1972).
126.
Sauvage, L.R., K. Berger and S.J. Wood.Vascular Grafts. P. N. Sawyer and M. J. Kaplitt, eds. Appleton-Century Crafts, pp. 185-196 (1977).
127.
Richardson, J.A. and H.A. McDonell. "Anastomatic Aneurysms Following Arterial Grafting: A 10 Year Experience," Ann. Surg., 184:179-182 (1975).
128.
Kinley, C.E. , P.E. Paasche and A.S. MacDonald. "Stress at Vascular Anastomosis in Relation to Host Artery: Synthetic Graft Diameter," Surgery , 75:28-31 (1974).
129.
Moore, W.S. , M. Chrapil, F. Seiffert and K. Keown. "Development of an Infection-Resistant Vascular Prosthesis," Arch. Surg., 116:1403-1407 (1981).
130.
Krajicek, M., J. Dvorak and M. Chrapil. "Infection-Resistant Synthetic Vascular Substitutes,"J. Cardiovasc. Surg., 10:453-457 (1969).
131.
Richardson, R.L., Jr., J.W. Pate and R.Y. Wolf. "The Outcome of Antibiotic-Soaked Arterial Grafts in Guinea Pigs' Wounds Contaminated with E Coli or S Aureus," J. Thorac. Cardiovasc. Surg., 59:635-637 (1970).
132.
Baker, W.H. and J.A. Badensteiner. "The Administration of Antibiotics in Vascular Reconstructive Surgery," J. Thorac. Cardiovasc. Surg., 64: 301-305 (1972).
133.
Clark, R.E. and H.W. Margraf. 'Antibacterial Vascular Grafts with Improved Thromboresistance," Arch. Surg., 109:159-162 (1974).
134.
Botzko, K.M., R. Snyder, J. Larkin and W.S. Edwards. "In-vivo/in-vitro Life-Testing of Vascular Prostheses", in Corrosion and Degradation of Implant Materials, ASTM STP 684, Philadelphia, PA:American Society for Testing and Materials, pp. 76-88 (1979).
135.
Snyder, R.W., B. Tonney and R. Guidoin. "Strength and Endurance of Vascular Grafts," in Vascular Grafts Update: Safety and Performance, ASTM STP 898, Philadelphia, PA:American Society for Testing and Materials , pp. 108-121 (1986).
136.
Smith, J.K. "Fatigue Testing of Medical Sutures," Closed Loop, Fall:12-18 (1986).
137.
Botzko, K.M. "Porosity Testing of Polyester Vascular Grafts," in Vascular Grafts Update: Safety and Performance, ASTM STP 898, Philadelphia: American Society for Testing and Materials , pp. 122-136 (1986).
138.
Campbell, C.D., D.H. Brooks andM.W. Webster. "Expanded Microporous Polytetrafluoroethylene as a Vascular Substitute: A Two Year Follow-Up," Surgery, 85:177-183 (1979).
139.
Veith, F.J. , C.M. Moss and S.C. Fell. "Comparison of Expanded Polytetrafluoroethylene and Autologous Saphenous Vein Grafts in High Risk Arterial Reconstructions for Limb Salvage," Surg. Gynec. Obstet., 147: 749-752 (1978).
140.
Veith, F.J. , C.M. Moss and S.C. Fell. "Expanded Polytetrafluoroethylene Grafts in Reconstructive Arterial Surgery," J.A.M.A.,240:1867-1869 (1978).
141.
Fry, P.D. and M.E. Robertson. "Initial Experience with the Polytetrafluoroethylene Graft for Limb Salvage," The A.J. Surg., 136:193-197 (1978).
142.
Campbell, C.D. , D.H. Brooks andM.W. Webster. "The Use of Expanded Microporous Polytetrafluoroethylene for Limb Salvage: A Preliminary Report," Surgery, 79:485-493 (1976)..
143.
Hobson, R.W., J.A. O'Donnell and Z. Jamil. "Below Knee Bypass for Limb Salvage," Arch. Surg., 115:833-837 (1980).
144.
Donaldson, M.C. and J.A. Mannick. "Femoropopliteal Bypass Grafting for Intermittent Claudication," Arch. Surg., 115:724-727 (1980).
145.
Veith, F.J. , D. Gupta and V. Daly. "Management of Early and Late Thrombosis of Expanded Polytetrafluoroethylene (PTFE) Femoropopliteal Bypass Grafts: Favorable Prognosis with Appropriate Reoperation" Surgery , 87:581-587 (1980).
146.
Gupta, S.K. and F.J. Veith. "Three Year Experience with Expanded Polytetrafluoroethylene Arterial Grafts for Limb Salvage," The A.J. Surg., 140:214-217 (1980).
147.
Veith, F.J. , S.K. Gupta and R.H. Samson. "Progress in Limb Salvage by Reconstructive Surgery Combined with New or Improved Adjunctive Procedures," Ann. Surg., 194:386-401 (1981).
148.
Weisal, R.D. , K.W. Johnston and R.J. Baird. "Comparison of Conduits for Leg Revascularization; ' Surgery, 89:8-15 (1981).
149.
Veith, F.J. , S.K. Gupta and V. Daly. "Femoropopliteal Bypass to the Isolated Popliteal Segment: Is Polytetrafluoroethylene Graft Acceptable?" Surgery, 89:296-303 (1981).
150.
Kidson, I.G. , D.W. Stoney, D.J. Tibbs and P.J. Morris. "Expanded Polytetrafluoroethylene Grafts for Severe Lower Limb Ischaemia," Br. J. Surg., 68:173-176 (1981).
151.
Pradham, D.J. , J.M. Juanteguy, E. Michelson and O. Abosch. "Results of Polytetrafluoroethylene Grafts in the Femoropopliteal Region: Two Year Evaluation of 146 Bypass Procedures " The Amer. Surgeon, 47:355-358 (1981).
152.
Yeager, R.A. , R.W. Hobson and Z. Jamil. "Differential patency and Limb Salvage for Polytetrafluoroethylene and Autogenous Saphenous Vein in Severe Lower Extremity Ischemia," Surgery, 91:99-103 (1982).
153.
Mason, R., A. Lanfranchi and F. Giron. "Isolated Popliteal Versus Distall Bypass for Limb Salvage ," Surg. Gynecol. Obstet., 155:49-53 (1981).
154.
LaSalle, A.J. , D.C. Brewster and J.D. Corson. "Femoropopliteal Composite Bypass Grafts: Current Status," Surgery, 92:36-39 (1982).
155.
Verta, M.J. , Jr. "Pedal Artery Bypass for Limb Salvage," Surg. Gynecol. Obstet., 155:401-405 (1982).
156.
Rosenthal, D., K. Levine, P.E. Stanton and P.A. Lamis. "Femoropopliteal Bypass: The Preferred Site for Distal Anastomosis," Surgery, 93:1-4 (1983).
157.
Ekman, C.A., G. Claes and I. Carlsson. "Use of Polytetrafluoroethylene Grafts in Elderly and High-Risk Patients;' Southern Medical Journal, 75: 1553-1555 (1982).
158.
Bergan, J.K., F.J. Veith and V.M. Bernhard. "Randomization of Autogenous Vein and Polytetrafluoroethylene Grafts in Femoral-Distal Reconstruction," Surgery, 92:921-930 (1982).
159.
Kaufman, J.L. , A.D. Whittemore, N.P. Couch and J.A. Mannick. "The Fate of Bypass Grafts to an Isolated Popliteal Artery Segment," Surgery, 92:1027-1031 (1982).
160.
Cranley, J.J. and C.D. Hafner. "Newer Prosthetic Material Compared with Autogenous Saphenous Vein for Occlusive Arterial Disease of the Lower Extremity ," Surgery, 89:2-7 (1981).
161.
Veith, F.J. , S.K. Gupta and R.M. Samson. "Superficial Femoral and Popliteal Arteries as Inflow Sites for Distal Bypasses," Surgery, 90:980-990 (1981).
Goldman, M. , M.C. Norcott and R.J. Mawker. "Femoropopliteal Bypass Grafts-An Isotope Technique Allowing In vivo Comparison of Thrombogenicity," Br. J. Surg., 69:380-382 (1982).
164.
Zieler, R.E. , P.D. Fry and I. Reid. "Revascularization of the Leg Using Polytetrafluoroethylene: Cumulative Patency in Patients with Claudication and Limb Salvage," The A. J. Surg., 143:549-53 (1982).
Adar, R. and N. Pliskin. "Cost Analysis of the Utilization of New Vascular Grafts ," in Graft Materials in Vascular Surgery. M. Dardick, ed. Symposia Specialists, Inc., pp. 337-348 (1978).
