Reinforced vascular grafts: a comparative study.

Reinforced vascular grafts are designed to resist compression and flexion forces, for example in axillo-femoral or below-knee femoropopliteal reconstruction. This study compared eight types of 6-mm reinforced grafts (five polytetrafluoroethylene (PTFE) and 3 Dacron). On a specially designed rig, graft diameter and flow were measured during compression by a standard series of weights up to 3.6 kg, and on another rig grafts were flexed through 135 degrees. Meadox Microvel graft resisted compression best (p less than 0.05) but there were no important differences between the other grafts (Vascutek; Bard; Goretex Standard, Thin Walled and Removable Ring; Impra Standard and Thin Wall). Flexion produced no significant changes in flow through the grafts. In addition, five general surgeons were asked to score the ease of removal of reinforcement, passage of sutures, and the tendency of sutures to cut out of each graft. Removal of reinforcement and passage of sutures were easier with the PTFE grafts, but the Dacron was more resistant to sutures cutting out. This study shows that these grafts resist flexion and compression well. Their different handling characteristics and data on patency at different sites should remain the main determinants in choice of graft.