Thrombogenicity of an elastomer-coated aortofemoral Dacron prosthetic graft in humans.

To determine the potential benefit of Dacron prostheses impregnated with silicon polymer, an elastomer-coated prosthetic graft (Intervascular [I]) was implanted in 30 patients with aortic occlusive arterial disease or infrarenal abdominal aortic aneurysm. These patients were compared with two other groups who underwent vascular reconstruction with either a knitted double-velour prosthesis (Meadow [M] or a knitted prosthesis (Bard-USCI [U]). The different prostheses were randomly allocated just prior to their insertion. Average blood loss was 1063.33 +/- 1065.69 ml for the I group, 888.33 +/- 575.85 ml for the M group, and 908.33 +/- 471.80 ml for the U group (NS). The duration of the operation was 160 +/- 56 minutes for the I group, 142 +/- 37 minutes for the M group, and 153 +/- 65 minutes for the U group (NS). The average follow-up was 12 months. As calculated by the actuarial method, primary patency at 36 months was 71.5% for the I group, 100% for the M group, and 98.2% for the U group (p < 0.001). Secondary patency was 73.7% for the I group and 100% for the M and U groups, respectively (p < 0.001). This study shows that the thrombogenicity of the elastomer-coated aortofemoral vascular prosthetic graft was significantly higher than that of the two other prostheses. Increased intraoperative blood loss and longer duration of operation were related to the aortic abnormality being treated (aneurysm or occlusion) rather than to the type of prosthetic graft being used.