Abstract
The objective of this study was to evaluate long-term integrity of knitted Dacron® and polytetrafluoroethylene (PTFE), as used in arterial prostheses, 4 to 20 years following graft implantation in patients. Graft durability following prosthetic graft placement is a frequently asked question from patients. In an effort to make a determination, the authors surgically obtained representative specimens of grafts clinically implanted 4 to 20 years before graft retrieval for histopathologic study. Eleven prosthetic arterial grafts, seven Dacron® and four PTFE, were retrieved from 10 patients and stained for study using paraffin-embedded histology sections. These were examined with light microscopy and polarized light microscopy. Graft specimens were taken, which prompted graft exploration and retrieval; these included thrombosis, stenosis, graft infection, and pseudoaneurysmal formation. No loss of integrity, fragmentation, or distortion of Dacron® or PTFE graft material was detected. Normal foreign-body reactions and healing with fibrosis were noted within the interstices of the Dacron® grafts and outer surfaces of Dacron® and PTFE grafts. No evidence of resorption or biodegradation was noted in any graft. Pseudointima was present on the luminal surface of Dacron® but not of PTFE grafts. Although no atherosclerotic changes were identified in the Dacron® grafts, focal areas of dystrophic calcification were present within the interstices of the PTFE grafts. The longterm (4 to 20 years) in vivo structural integrity of the Dacron® and PTFE grafts studied is supported by our data. Whereas the foreign-body reaction macrophages and foreign-body giant cells of the material interface have the potential to resorb or biograde the material, data in these studies suggest Dacron® and PTFE are resistant to biodegradation for at least two decades. These data support the continued use of these materials in fabrication of arterial prostheses.
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