EARLY RESULTS OF 132 AORTIC OR AORTOILIAC ARTERIAL RECONSTRUCTIONS WITH THE NEW STRETCH EPTFE VASCULAR PROSTHESIS

Objective: The purpose of the present study is to document the short t erm clinical results after implantation of the new Stretch ePTFE (Gore -Tex) arterial prostheses in patients with aortic or aorto-iliac occlu sive atherosclerotic disease or aneurysm. Study design: A descriptive, prospective and non-randomized clinical series with clinical follow-u p at three and 12 months. Setting: The study was performed at an Acade mic Vascular Surgery Unit. Patients: Within 20 months we consecutively implanted 379 prostheses (tubes or bifurcations): 132 Stretch ePTFE ( Gore-Tex) and 247 Dacron (Unigraft, Eraun-Melsungen) grafts. Results: There was no intraoperative deaths. Nine of 217 patients (=4%) with oc clusive atherosclerotic disease died <30 days postoperatively; the mor tality rate for asymptomatic aortic aneurysm was 8% (7/91), for sympto matic aneurysm 13% (4/30), and for ruptured aneurysm 22% (8/36). The p rimary patency of the aortic or aorto-iliac grafts was 99%, secondary patency at three months and one year 100 per cent. One patient with St retch prosthesis developed a superficial groin infection, and one deve loped infection of an aortic tube graft. In the Dacron series six pati ents developed superficial groin infection, and two deep infections oc curred. No graft-enteric fistulas or erosions were seen, and by clinic al examination no anastomotic aneurysm developed. Five patients had in situ replacement of a pan-infected Dacron bifurcation graft with a Go re-Tex Stretch graft. With an observation time from 50 to 400 days the se five patients are well without clinical signs of infection. Conclus ions: These short term results with implantation of aortic or aorto-il iac Stretch ePTFE prostheses are encouraging and will provide the basi s for a continuing performance trial with long term follow-up and repo rting.