Longitudinal forces acting on a knitted polyester arterial prosthesis when implanted as a thoracic aorta substitute...

The longitudinal forces under which arterial prostheses are held in situ are of great importance. The tension caused by the longitudinal force may be one of the factors involved in the formation of anastomotic false aneurysms. In order to measure the changes in the longitudinal force at both proximal and distal end-to-end anastomoses over different periods of implantation, we devised an experimental study in which the changes in length of a warp-knitted polyester VP1200K (Vascutek Ltd., Inchinnan, Scotland) arterial prosthesis, used as a thoracic aorta substitute in the dog, were recorded photographically at implantation and removal. The longitudinal forces acting at the two sites were then calculated using a linear relationship between the longitudinal force and the changes in length of a virgin prosthesis, which was found experimentally in vitro using a computerized laser calibration system. One-tailed Student's t-test showed no significant difference between the length indicator values at the two anastomotic sites at different periods of implantation except during the 1-month period. Textile analysis of the explanted prostheses and histopathologic observations confirmed this similar behavior at the two anastomotic sites. These observations were contrary to the theoretic prediction regarding the effect of forces applied by drag and tissue ingrowth. Nevertheless, analysis of variance confirmed that there was no difference evident at the two sites between different implantation periods. These observations may explain why the formation of anastomotic false aneurysms is less common at end-to-end anastomoses.