MYOINTIMAL HYPERPLASIA IN VEIN COLLARS FOR EPTFE GRAFTS

Objective: To understand the cause of intermediate ePTFE graft failure when a venous boot is used. This might give insight into the improvem ent in patency that results from the use of a venous boot. Design: A h istological and radiological study of failed and failing grafts. Metho ds: A review of patients operated upon in St Mary's Hospital under the care of a single consultant. Results: Four anastomoses were retrieved following irretrievable occlusion and found to have myointimal hyperp lasia at the junction between the ePTFE graft and collar. The artery w as relatively spared. In a further six patients these results have bee n corroborated by angiography. Conclusion: Myointimal hyperplasia occu rs at the interface between ePTFE and vein collar and the recipient ar tery is relatively spared. This manipulation of the site of myointimal hyperplasia may result in improved patency rates.