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Histologic Evaluation of Dacron® and PTFE Graft Material Explanted From Humans After 4 to 20 Years In Vivo

Division of Vascular Surgery, Ellis Hospital, Schenectady; The Institute for Vascular Health and Disease, Albany Medical College, Albany, New York

James M. Anderson, MD, PhD

Department of Pathology, Case Western Reserve University, Cleveland, Ohio

Michael L. Gelfand, MD

Paul S. Skudder, MD

Carol A. Bowers, RN, CVN

Division of Vascular Surgery, Ellis Hospital, Schenectady; The Institute for Vascular Health and Disease, Albany Medical College, Albany, New York

The objective of this study was to evaluate long-term integrity of knitted Dacron® and polytetrafluoroethylene (PTFE), as used in arterial prostheses, 4 to 20 years following graft implantation in patients. Graft durability following prosthetic graft placement is a frequently asked question from patients. In an effort to make a determination, the authors surgically obtained representative specimens of grafts clinically implanted 4 to 20 years before graft retrieval for histopathologic study. Eleven prosthetic arterial grafts, seven Dacron® and four PTFE, were retrieved from 10 patients and stained for study using paraffin-embedded histology sections. These were examined with light microscopy and polarized light microscopy. Graft specimens were taken, which prompted graft exploration and retrieval; these included thrombosis, stenosis, graft infection, and pseudoaneurysmal formation. No loss of integrity, fragmentation, or distortion of Dacron® or PTFE graft material was detected. Normal foreign-body reactions and healing with fibrosis were noted within the interstices of the Dacron® grafts and outer surfaces of Dacron® and PTFE grafts. No evidence of resorption or biodegradation was noted in any graft. Pseudointima was present on the luminal surface of Dacron® but not of PTFE grafts. Although no atherosclerotic changes were identified in the Dacron® grafts, focal areas of dystrophic calcification were present within the interstices of the PTFE grafts. The longterm (4 to 20 years) in vivo structural integrity of the Dacron® and PTFE grafts studied is supported by our data. Whereas the foreign-body reaction macrophages and foreign-body giant cells of the material interface have the potential to resorb or biograde the material, data in these studies suggest Dacron® and PTFE are resistant to biodegradation for at least two decades. These data support the continued use of these materials in fabrication of arterial prostheses.

Vascular and Endovascular Surgery, Vol. 34, No. 6, 505-512 (2000)
DOI: 10.1177/153857440003400601


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