Vascular Prosthetics: the Gore-Tex ePTFE Stretch Graft

Following introduction of the Gore-Tex stretch vascular graft in 1991, over 15,000 bifurcated and 35,000 straight grafts have been distributed (Figure I). This novel graft, recommended for arterial and venous reconstruction, is touted to afford significantly superior handling characteristics, kink-resistance and conformability. In addition, the "stretch" feature is thought to confer ease of sizing and anastomotic accuracy. Whether this product of advanced polymer science represents a panacea in the field of vascular grafting or a mere addition to the host of less than ideal synthetic conduits remains to be discerned. The first human implantation of a stretch graft was conducted by one of the authors (R.T.G.) during aortic replacement at the Eastern Virginia Medical School (EVMS). A favorable experience has since been gained by utilization of the stretch graft during vascular reconstruction for aortoiliac, infrainguinal and visceral arterial disease. This review will present the intriguing history of synthetic graft development and recount our experience with the Gore-Tex stretch vascular graft.