Arterial substitutes in peripheral vascular surgery: a review

A large proportion of general vascular surgery involves diagnosis and operative treatment of disorders of the arterial system. To a great extent, advances in the operative care of patients with arterial disease have been dependent on the development of clinically satisfactory arterial substitutes. Currently, based on extensive basic research and clinical experience, prosthetic grafts are preferred as substitutes for larger caliber arteries, while autogenous veins provide the best results as substitutes for smaller, lower flow vessels in the extremities. In this review, we examine the arterial substitutes that have been and are currently important in the clinical practice of general vascular surgery. From this material, it should be apparent to the reader that the perfect arterial substitute does not exist and all, when implanted in humans, are associated with well-recognized short and long term complications.