The problem of small vessel grafting and the flexion crease: A comparison between autogenous vein and dacron grafts

Abstract

Present limitations of distal peripheral vascular surgery are related primarily to problems associated with grafts spanning flexion creases and the high incidence of graft thrombosis in very small vessels. To determine the suitability of autogenous vein grafts under these circumstances fourteen Dacron grafts and fourteen autogenous vein grafts were inserted simultaneously into the canine femoral flexion area. Aortograms obtained two months following operation revealed 93 per cent patency of the autogenous vein grafts, as compared to 36 per cent patency of the Dacron grafts. Occlusion of the Dacron grafts appeared to be a function of small diameter, with occlusion due to fibrin build-up, rather than due to factors inherent in the Dacron. It did not appear to be related primarily to stresses associated with the placement of the Dacron grafts over areas of marked flexion. Therefore, it would appear that although Dacron is the graft material of choice in most instances, autogenous vein grafts may be superior when dealing with distal peripheral arteries of very small diameter.