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Abstract
Five patients with knitted Dacron aortic bifurcation prostheses developed prosthetic
dilation and anastomotic false aneurysms. The interval between placement of prostheses
and secondary presentation ranged from 4 to 10 years. Three patients presented with
femoral false aneurysms (one ruptured) and two presented with aortic false aneurysms
(one ruptured). In all cases, anastomotic sutures remained intact on the prosthesis
and there was no evidence of infection. The mean (±SEM) increase in diameter of prostheses
was 85.7 ± 19.1% (range 76% to 137%). Dilated prostheses were removed in four cases
and were tested for tensile strength and studied with scanning electron microscopy.
These were compared to normal, nondilated knitted Dacron prosthetic fabric from the
same manufacturer. There was no loss of breaking strength in dilated prostheses. Furthermore,
on examination with scanning electron microscopy, there was no evidence of degeneration
or fracturing of individual Dacron filaments. However, dilated prostheses were found
to have a greatly expanded knit. The distance between loops was significantly increased
and the number of fibers per 1000 μm was significantly less in comparison to normal
knitted Dacron fabric. These studies confirm an association between prosthetic dilation
and false aneurysm formation. Further, they suggest that the cause of prosthetic dilation
is loss of compactness of the knit not associated with intrinsic Dacron fiber deterioration.
A fabrication defect is most likely responsible.
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Article info
Footnotes
☆Presented at the Sixth Annual Meeting of the Southern Association for Vascular Surgery, Marco Island, Fla., Jan. 29–30, 1982.
☆☆The views or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
Identification
Copyright
© 1983 Published by Elsevier Inc.
