The modified bovine carotid artery as a vascular substitute in man. Personal experience and review of the literature.

The modified bovine heterograft is one of the vascular prostheses currently available for clinical use. This report reviews the mode of preparation of the heterograft and its physical and biological qualities. The experience of the authors with this heterograft for vascular reconstruction in 32 patients and for the construction of s.c. arteriovenous (A-V) fistulas in 80 patients is reported. The modified bovine heterograft was found to be a satisfactory prosthesis when used in vascular reconstruction above the inguinal ligament or for the construction of A-V fistulas for hemodialysis. In reconstructions in the femoropopliteal segment of the circulation, the use of the heterograft by the authors was associated with an unacceptable rate of morbidity and graft failures. Experience reported in the literature has so far been incomplete and inconclusive, with one-year patency rates ranging between 20 and 74%.