Longitudinal ruptures of polyester knitted vascular prostheses

Area of Science:

• Biomaterials science
• Vascular surgery
• Materials engineering

Background:

• Warp-knitted polyester vascular prostheses are widely used for bypass grafting.
• Late graft failure can occur due to various mechanisms, including rupture.
• Understanding rupture mechanisms is crucial for improving graft design and patient outcomes.

Purpose of the Study:

• To characterize the specific type of longitudinal rupture observed in explanted warp-knitted polyester vascular prostheses.
• To identify the anatomical locations and underlying causes of these ruptures.

Main Methods:

• Analysis of 20 explanted warp-knitted polyester vascular prostheses with longitudinal rupture.
• Macroscopic examination, optical stereomicroscopy, and scanning electron microscopy.
• Correlation of rupture characteristics with clinical implantation data.

Main Results:

• Ruptures predominantly occurred along the guide line and remeshing line of the prostheses.
• Mean implantation duration was 16.0 years, with ruptures observed between 9-20.7 years.
• Scanning electron microscopy revealed degradation of trilobar velour filaments and gradual ruptures of remeshing and guide line filaments.

Conclusions:

• A specific mechanism of late longitudinal rupture in knitted polyester prostheses has been identified.
• This rupture is characterized by the degradation of polyester filaments along the graft's length, specifically at the remeshing and guide lines.
• Findings provide insights into the long-term performance and failure modes of these vascular grafts.