Favorable histologic findings and tensile strength at 14 years in knitted polyester aortofemoral and femoropopliteal grafts in the same patient

Patent right and left limbs of an aortobifemoral knitted polyester graft an d a patent left femoropopliteal graft, both implanted for 14 years, were re moved 40 hr postmortem from a 63-year-old man. Healing studies were perform ed, using routine and immunocytochemistry staining scanning electron micros copy (SEM), and transmission electron microscopy (TEM) on multiple samples taken from sites sufficiently far from the anastomoses to avoid pannus heal ing. Evaluation by weight-elongation comparison with a fresh graft demonstr ated that structural stability and strength were well preserved. Anastomose s were, patent with no remarkable intimal hyperplasia. There was no thrombu s on the flow surface of either graft. Histologic studies of these grafts r evealed uniform through-wall tissue ingrowth and extensive patches of endot helial cells, scattered over the flow surface, confirmed: by factor VIII, S EM, and TEM. These findings document that long-term stable tensile strength . and healing with flow surface endothelialization can be attained with kni tted polyester grafts, in the human.