Van Damme H, Deprez M, Creemers E, Limet R
Service de Chirurgie Cardio-Vasculaire et Thoracique, Hôpital Universitaire de Liège, CHU du Sart-Tilman, Liège, Belgique.
Acta Chir Belg. 2005 May-Jun;105(3):249-55. doi: 10.1080/00015458.2005.11679712.
Intrinsic structural failure of Dacron prostheses is a late exceptional complication, resulting from a loss of structural integrity of the graft. The authors report six cases of non-anastomotic false aneurysms in the mid-portion of a vascular Dacron graft, observed at a mean of 12 years after insertion. It concerns four femoro-popliteal bypass grafts, one cross-over graft and a branch of a bifurcated aorto-bifemoral graft, implanted between 1980 and 1990. This represents 0.2% of all vascular Dacron grafts implanted in authors' department since 1980. The degenerated prosthesis was excised, and a new bypass graft was inserted. In three cases, histological analysis revealed a foreign body giant cell reaction against fragmented Dacron fibers. In none of the cases there was evidence of graft infection. The authors discuss the evidence and etiopathogeny of this late, unusual complication, inherent to the Dacron graft material. The most probable causative factor is material fatigue, leading to gradual breakdown and fragmentation of individual fibers, and subsequent biodegradation of the basic material. Such an intrinsic weakness of prosthetic fabric has only be observed in first and second generation Dacron grafts.
涤纶人工血管的内在结构破坏是一种罕见的晚期并发症，是由移植物结构完整性丧失所致。作者报告了6例血管涤纶移植物中段非吻合口假性动脉瘤病例，这些病例在植入后平均12年被观察到。其中包括4例股腘动脉搭桥移植物、1例交叉移植物和1例分叉型主动脉-双股动脉移植物的分支，植入时间在1980年至1990年之间。这占自1980年以来作者所在科室植入的所有血管涤纶移植物的0.2%。将退变的人工血管切除，并植入新的搭桥移植物。在3例病例中，组织学分析显示对破碎的涤纶纤维有异物巨细胞反应。所有病例均无移植物感染的证据。作者讨论了这种涤纶移植物材料固有的晚期罕见并发症的证据和病因。最可能的致病因素是材料疲劳，导致单根纤维逐渐断裂和破碎，随后基础材料发生生物降解。这种人工血管织物的内在弱点仅在第一代和第二代涤纶移植物中观察到。
