COMPLIANCE OF VASCULAR ANASTOMOSES WITH POLYBUTESTER AND POLYPROPYLENE SUTURES

Purpose: Polybutester suture is more easily stretched than other vascu lar sutures and may produce more compliant anastomoses. The effects of using polybutester and polypropylene sutures were compared acutely in arterial autografts and in chronic implants of cephalic vein grafts i nto the femoral arteries of dogs. Methods: Paraanastomotic profiles of diameter and compliance were measured with echo-tracked ultrasonograp hy, and profiles of intimal thickening were generated from histologic sections of the vessels harvested after 3 months. Results: Polybuteste r produced more compliant anastomoses, compared with polypropylene, in arterial autografts (in vitro: 5.9% +/- 2.0% vs 3.3% +/- 0.6% diamete r change/100 mm Hg, p < 0.01; in vivo: 3.1% +/- 1.1% vs 1.6% +/- 0.5%, p < 0.05), but this difference was not observed with vein as the graf t material, either initially (1.1% +/- 1.2% vs 1.7% +/- 0.5%) or after 3 months (2.1% +/- 1.2% vs 2.4% +/- 0.8%). This dichotomy may reflect a governing influence of the stiffer veingrafts, compared with host a rtery (2.6% +/- 1.0% vs 5.4% +/- 1.2%), or the use of suboptimal tensi on on the polybutester suture when creating the anastomosis. Conclusio ns: Both sutures produced similar compliance and thickness profiles. P olybutester initially produces a more compliant anastomosis when both artery and graft are compliant, reducing anastomotic compliance mismat ch. However, this benefit may not apply when the anastomosis includes a vessel of low compliance.