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Lateral patch graft angioplasty of both arteries and large veins may be successfully performed with a variety of materials. The specific material used does not effect luminal patency of canine vessels approximately 5 mm. or larger followed for periods of 6 to 12 months. Smaller arteries show occasional occlusions after patch grafting, and autogenous vein is somewhat better than synthetic patches. The failure rate in tiny 1 mm. arteries is very high.
Better incorporation of autogenous vein patch grafts into the vascular wall leads to some preference for them over synthetics in all vessels, particularly those of small size. Other autogenous materials including fascia, peritoneum, and bowel wall appear promising experimentally but have not yet been tried clinically.
Other recommendations for clinical use include: (A) use of patch grafts only when necessary to obtain an adequate vascular lumen; (B) use of the more easily placed synthetic patch grafts when exposure is difficult or operative time is of importance: and (C) proper use of a patch graft to enlarge the vascular lumen at the point where a thromboendarterectomy ends.
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☆Supported by National Heart Institute Grant HE-06070.
☆☆Presented at the Eighteenth Annual Meeting of the Society for Vascular Surgery, San Francisco, Calif., June 21, 1964.
© 1965 Published by Elsevier Inc.