Knitted dacron grafts used for abdominal aortic reconstruction: sizing references

Area of Science:

• Vascular Surgery
• Biomaterials Science
• Medical Imaging

Background:

• Aortic disease necessitates the use of vascular grafts for repair.
• Knitted Dacron grafts are commonly used, but their sizing and dilation characteristics require evaluation.
• Accurate graft diameter assessment is crucial for surgical planning and patient outcomes.

Purpose of the Study:

• To analyze immediate and mid-term dilation of knitted Dacron grafts.
• To determine reliable reference parameters for evaluating aortic graft dilation.
• To compare graft diameters from initial sizing to long-term follow-up.

Main Methods:

• Implantation of Dacron knitted microvel double velour vascular grafts in 30 patients.
• Measurement of graft external diameter using calipers intraoperatively and ultrasound/CT postoperatively at 1, 6, and 12 months.
• Statistical comparison (Student's t-test) of measurements from package sizing, intraoperative readings, and imaging follow-ups.

Main Results:

• A statistically significant difference was observed between package sizing and intraoperative measurements (p < 0.01), with grafts showing 22-28% increase in diameter.
• No significant difference in diameter was found between post-clamp release measurements and ultrasound readings at 4 weeks and 6 months.
• A statistically significant dilation (p = 0.04) was noted by CT at 1 year compared to the post-clamp release reference, while ultrasound showed an almost significant increase (p = 0.08).

Conclusions:

• Package sizing of knitted Dacron grafts is not a reliable indicator of actual size.
• Immediate graft dilation is influenced by discrepancies in sizing and textile adaptation.
• Ultrasound or CT in the immediate postoperative period is recommended for establishing a reliable reference diameter for graft dilation assessment.