COATED POLYESTER GRAFTS - A THEORETICAL A DVANTAGE

Leak-proof polyester grafts impregnated with collagen, gelatine or alb umin are routinely used in vascular surgery. Theoretically, there are several advantages: no need for pre-coagulation, reduced operation tim e and graft manipulation, less blood loss during the operative period, better healing with a potentially greater resistance to infection. We analyzed all the publications in scientific journals to verify whethe r these theoretical advantages are validated by clinical trials. There have been 12 non-comparative series reporting favourable results bur the lack of control groups makes it difficult to draw conclusions. Fiv e comparative series with random assignment of patients have been repo rted. None of these series showed a substantial benefit from impregnat ion. Thus the use of an impregnated polyester graft would not appear t o be justified for routine standard aorto-iliac surgery. Conversely, a lthough no evidence has been provided by a comparative study, the majo r risk of haemorrhage in procedures such as extracorporal circulation, the thoracic or abdominal aorta and in patients with a coagulation di sorder, impregnated graft probably constitute an important progress (J Mal Vasc 1996; 21, Suppl. A : pages 41-47).