Effect of geometric taper on thrombosis in vascular prostheses: an ex vivo study

A common method of assessing the thrombogenicity of prosthetic arterial grafts is to determine the amount of platelets and fibrin that accumulates on their surfaces. This study was designed to compare thrombus formation in cylindrical and tapered vascular grafts (angle of taper 0.5 deg) made from the same biomaterial. Turbulence was generated upstream of the grafts by means of a 75% axi-symmetric stenosis. In general, turbulence is dissipated by the effect of blood viscosity, whereas in a tapered graft, there is an additional reduction in the intensity of turbulence owing to the effect of converging flow through the taper. The aim of this study was to assess the effect of turbulence on thrombus formation in cylindrical and tapered grafts. After blood had circulated for 2 and 4 h through the cylindrical and tapered grafts, which formed part of two parallel ex vivo circuits, platelet deposition and fibrinogen uptake were measured by means of a radioisotope technique. Although the flow disturbances were less in the tapered grafts, no significant difference in platelet and fibrin deposition in the two types of graft was observed at 2 h. For the longer perfusion time, however, increased platelet and fibrin activity was recorded in the annular vortex region in the tapered grafts. In general, neither platelets nor fibrin accumulated in areas of high turbulence intensity.