Vascular Grafts: Clinical and Hemodynamic Applications

Abstract

Early experiments in the development of vascular grafts began with simple tubes of impervious nonbiologic material placed into the arterial circulation of animals. These experiments were largely unsuccessful, however, with high rates of thromboembolism and hemorrhage related to lack of coverage of the graft lumen by a biologic surface and failure of incorporation of the synthetic materials into the perivascular tissues. In 1906, Carrel reported experiments with homologous and heterologous artery and vein grafts placed in the canine arterial circulation(1). In that same year, Goyanes replaced a segment of human artery with autologous vein(2). Despite this early work with vascular grafts, treatment of most arterial injuries as late as World War II was by ligation(3). In 1952, however, Dubost made a landmark contribution by repair of an aortic aneurysm with an arterial homograft(4). The subsequent introduction of Vinyon-N as a synthetic graft materials(5) ushered in a new era of elective arterial reconstruction. Repair of arterial injuries, also, soon became commonplace.