Polyester arterial prostheses. Recent developments from the Czech Republic and Poland.

Abstract

To evaluate recent developments in the design and production of polyester vascular prostheses in eastern Europe, a series of in vitro physical and chemical tests and an in vivo study was performed on three new prototype devices from the Czech Republic and one from Poland. The in vitro results for these four prostheses, referred to as the Ra-1n (warp knitted, uncrimped), Ra-1v (warp knitted, crimped), Mikrofroté (weft knitted, uncrimped), and Dallon (warp knitted, crimped) prostheses, were compared against values for three commercial devices of western origin, namely the Triaxial, the Vasculour II, and the Cooley II grafts. The animal trial involved implanting the four prototype devices as a thoracoabdominal bypass in dogs for eight different periods ranging from 4 hrs to 6 months and undertaking histologic and structural investigations on the retrieved grafts. Because of its poor long-term dimensional stability in vivo, the continued use of a weft knitted structure, like the Mikrofroté prosthesis, is to be deprecated. Conversely, the introduction of a more dimensionally stable warp knitted structure in three prototypes is to be acknowledged. However, the presence of surface contaminants was most likely responsible for the excessive inflammatory reaction generated by all four prostheses during the first month in vivo, which resulted in delayed healing performance. In addition, an unusually high surface carbon-oxygen ratio suggests that the crimping process needs further refinement. Improved cleaning and packaging procedures are essential before these products can complete against existing commercial prostheses of western origin. In conclusion, these new developments illustrate that the technology of warp knitting, which is now spreading worldwide, should be evaluated.