The effect of porosity and biomaterial on the healing and long-term mechanical properties of vascular prostheses.

Continuing efforts in vascular prosthetic design are focused on understanding the characteristics required for function of small internal diameter and low-flow prostheses. The pioneers of vascular surgery developed large diameter textile prostheses for successful reconstruction of the aortoiliac vessels, but fabric grafts function poorly in diameters less than six millimeters. Major advances in small vessel reconstruction include the use of autogenous vessels for coronary artery lesions and microvascular surgery of digital and cerebral vessels. The author believes that future advances in graft design will enable prosthetic repair of two to four millimeter arteries and reconstruction of veins. This manuscript discusses the development of improved synthetic blood compatible surfaces with detailed consideration of prosthetic design factors such as pore size, biomaterial mechanical properties and thrombogenicity of the blood flow surface.