Calcification of Synthetic Vascular Grafts: A Systematic Review

Abstract

Calcification of vascular grafts, including polyethylene terephthalate (PET) and expanded polytetrafluoroethylene (ePTFE) grafts may contribute to graft failure, but is under-reported. The aim of this study was to review to review the literature to assess whether vascular graft calcification is deleterious to vascular graft outcomes. The Medline and Embase databases were searched. A systematic literature search according to PRISMA Guidelines was performed using a combined search strategy of MeSH terms. The MeSH terms used were “calcification, physiologic”, “calcinosis”, “vascular grafting”, “blood vessel prosthesis”, “polyethylene terephthalates”, and “polytetrafluoroethylene”. The systematic search allowed the identification of 17 cases of PET graft calcification and 73 cases of ePTFE graft calcification over a 35 year period. All cases of PET graft calcification were reported in grafts explanted for graft failure. The majority of cases of ePTFE graft calcification have been unexpectedly noted in grafts used during cardiovascular procedures and subsequently removed. Calcification of synthetic vascular grafts is under-reported, but can compromise the long term performance of the grafts. More data, including specific analysis of radiological findings as well as explant analysis are needed to obtain a more sensitive and specific analysis of the prevalence and incidence of vascular graft calcification and the impact of calcification on synthetic graft outcomes.