Five types of polyurethane vascular grafts in dogs: the importance of structural design and material selection

Five polyurethane vascular grafts with three different chemistries were investigated in terms of device function, healing characteristics and material stability in a canine abdominal aorta model for prescheduled periods of 1 and 6 months. Corvita-reinforced grafts, with walls made of poly(carbonate urethane) (PCU) filaments, displayed a relatively thin, uniform and partially endothelialized inner capsule with good tissue in-growth. The external polyester mesh separated from the underlying PCU wall due to the degradation of the melt adhesive between these two layers. Three types of Thoratec access graft exhibited a high degree of thrombus and little tissue in-growth, and were non-adhesive to both the inner and external capsules as the solid layer beneath their lumens completely blocked any transmural communication. The microporous poly(ether urethane urea) degraded extensively. Pulse-Tec grafts at one month also demonstrated non-adhesive properties because the external skin served as a barrier to tissue in-growth. At 6 months, its poly(ether urethane) wall displayed the most severe degradation, damaging graft structural integrity and causing significant tissue deposition in the degradation areas. This study shows the importance of multiple factors in vascular prosthesis design and demonstrates that collective and comprehensive thinking will be key in the future development of creative and novel approaches.