Collagen versus gelatin-coated Dacron versus stretch polytetrafluoroethylene in abdominal aortic bifurcation graft surgery: Results of a seven-year prospective, randomized multicenter trial

Background. A prospective randomized multicenter trial was performed to com pare knitted gelatin-coated Dacron bifurcation grafts, knitted collagen-coa ted Dacron grafts, and stretch polytetrafluoroethylene (PTFE) grafts. Methods. Between 1991 and 1998, 315 elective patients were randomized by ag e, gender, diabetes, runoff, indication (aneurysm, aortoiliac occlusive dis ease), and nicotine consumption at 3 centers of vascular surgery in Austria . The patients received gelatin-coated Dacron (GEL-D) grafts (n = 109), col lagen-coated Dacron (COL-D) grafts (n = 100), or stretch PTFE grafts (n = 1 06). Results. No intraoperative deaths occurred. The 30-day mortality was 3 %. N o difference was found between the 3 graft materials in long-term patency. The primary 5-year patency rates were 92 % for GELD, 89 % for COL-D, and 91 % for stretch PTFE (P = .6001). The secondary 5-year patency rates also di ffered: 97 % for GEL-D, 100 % for COL-D, and 97 % for stretch PTFE ( = .206 2). Early occlusions were observed overall in 3 % and late occlusions in 5 % of patients. When both Dacron grafts were compared collectively with stre tch PTFE, a difference was found in infection rate: Dacron 3 % (6/209) vers us PTFE 0 % (0/106); P < .03. Conclusions. The bifurcation grafts of all 3 materials were comparable in p rimary and secondary patency rates, incidence of false aneurysms, and rate of perioperative complications. Graft infections were confined to the 2 Dac ron grafts and did not occur in stretch PTFE grafts.