Vascular grafts in the elderly.

The incidence of symptomatic atherosclerotic occlusive disease is increasing as the life expectancy of our population rises. Most prosthetic vascular grafts are made of Dacron, which can be knitted or woven, depending on degree of porosity desired. Atherosclerotic occlusive disease can be classified by location: Group I, disease in the coronary arteries, usually treated by arterial bypass surgery; Group II, disease in the brachiocephalic vessels, usually treated by carotid endarterectomy; Group III, disease in the branches of the abdominal aorta, usually treated by a bypass from the aorta to the affected artery; and Group IV, disease in the terminal abdominal aorta and its branches, usually requiring aortofemoral bypass graft. Another type, aneurysm, usually requires resection and graft replacement. Despite advancing age, patients with atherosclerosis, when properly selected, can benefit from reconstructive vascular surgery without excessive risk.