Dacron Polyester

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Charles Mccollum - One of the best experts on this subject based on the ideXlab platform.

  • heparin bonded Dacron or polytetrafluoroethylene for femoropopliteal bypass grafting a multicenter trial
    Journal of Vascular Surgery, 2001
    Co-Authors: C. Devine, B A Hons, Charles Mccollum
    Abstract:

    Abstract Background: Dacron (Polyester fiber) was largely abandoned for femoropopliteal bypass grafts 30 years ago because saphenous vein achieved better patencies. However, in patients taking aspirin, patency in above-knee femoropopliteal bypass grafts has recently been shown to be equivalent to that with saphenous vein. We compared heparin-bonded Dacron (HBD) and polytetrafluoroethylene (PTFE) in a randomized multicenter trial including below-knee popliteal or tibioperoneal trunk bypass graft where the long saphenous vein was absent or inadequate. Methods: Over 28 months, 209 patients undergoing femoropopliteal bypass grafts (180 above-knee, 29 below-knee) were randomized to HBD (n = 106) or PTFE (n = 103). Each patient was given aspirin (300 mg/d) before surgery, and this continued unless the patient had intolerance to the aspirin. Results: The mean follow-up was 42 months (range, 28-55). Fifteen (7.1%) patients died with patent grafts, and three (1.4%) infected grafts were removed. Patency (measured with Kaplan-Meier survival analysis) at 1, 2, and 3 years for HBD was 70%, 63%, and 55% compared with 56%, 46%, and 42%, respectively, for PTFE ( P =.044). A total of 67 secondary interventions were performed on 48 thrombosed grafts; long-term patency was achieved in only three. Risk factors for arterial disease did not significantly influence patency. Amputations have been performed in 23 patients, six after HBD and 17 after PTFE bypass grafts ( P =.015). Conclusions: HBD achieved better patency than PTFE, which carried a high risk of subsequent amputation. (J Vasc Surg 2001;33:533-9.)

Edward H Garrett - One of the best experts on this subject based on the ideXlab platform.

  • prosthetic above knee femoropopliteal bypass grafting results of a multicenter randomized prospective trial
    Journal of Vascular Surgery, 1997
    Co-Authors: William M Abbott, Richard M Green, Teruo Matsumoto, Jock R Wheeler, Normand Miller, Frank J Veith, William D Suggs, Larry H Hollier, Samuel R Money, Edward H Garrett
    Abstract:

    Abstract Purpose: There are excellent arguments in favor of the preferential use of prosthetic grafts above the knee for the treatment of infrainguinal occlusive disease. This approach has been popularized on the basis of the seemingly acceptable results when using polytetrafluoroethylene (PTFE). However, in many centers, knitted Dacron Polyester has been used in these patients, and there are several studies that show equivalent and, in some, superior results with Dacron when compared with PTFE. The purpose of this study was to examine these results in a definitive way. Methods: A randomized prospective trial in eight clinical academic centers in the United States and Canada was initiated in 1991. Two hundred forty-four patients eligible for such a study, by virtue of criteria extant in each institution at the time, were centrally randomized. They underwent placement of either a knitted Dacron Polyester graft impregnated with collagen or a thin-wall expanded reenforced PTFE graft to the above-knee popliteal artery, usually from the common femoral artery. They were frequently observed by protocol for as long as 5 years by a physical examination noninvasive hemodynamic study, including duplex scanning in many instances. Continuing patency was noted, as were other potential adverse outcome events. The data were analyzed by the log-rank test for cumulative patency and expressed as Kaplan-Meier curves. Data were further analyzed with a Cox proportional hazards model. Results: There were no differences in graft groups in demographic or comorbid factors. The procedural mortality rate was zero, and the morbidity rate was low (6.5%). The long-term patient survival rate was excellent (77% at 3 years). At the end of these years, no statistical significance in primary or secondary patency rates was observed between the two grafts (primary patency rate, 62% ± 14.4% for Dacron; 57% ± 15.5% for PTFE). No unexpected adverse outcomes on limb status were noted. Patency rates in both graft groups were inferior in patients who received small grafts (5 to 6 mm vs 7 to 8 mm; hazards ratio, 4.15) and younger ( Conclusions: The fact that these two prosthetic grafts performed in equivalent fashion in a controlled, well-conducted prospective study is not surprising in spite of the previous work that suggested differences. If the preferential use of synthetic bypass grafts above the knee is to be used, it should be restricted to older nonsmokers with favorable anatomy. In that instance, the choice of graft material will depend on handling characteristics and cost. Above-knee prostheses should be only selectively used in younger, smoking patients, and graft size should be carefully considered in patients who undergo this operation. (J Vasc Surg 1997;25:19-28.)

Frank W. Logerfo - One of the best experts on this subject based on the ideXlab platform.

  • glycoconjugate mediated endothelial cell adhesion to Dacron Polyester film
    Journal of Vascular Surgery, 1993
    Co-Authors: Keith C Ozaki, Matthew D. Phaneuf, William C. Quist, Suchen L Hong, Frank W. Logerfo
    Abstract:

    Abstract Purpose:  The purpose of this study was to explore new strategies for enhancing specific cell type attachment to biomaterials using immobilized lectins for cell surface glycoconjugates. The lectin Ulex europaeus I (UEA I) has a high affinity for human vascular endothelial cell surface glycoconjugates. Methods:  UEA I was covalently bound to polyethylene terephthalate (Dacron) with the cross-linking agent 1-ethyl-3-(dimethylaminopropyl) carbodiimide hydrochloride to achieve oligosaccharide-mediated endothelial cell attachment to this otherwise nonadherent surface. Results:  Experiments with radiolabeled UEA I demonstrated covalent linkage of as much as 1.35 μg/cm 2 . The lectin binding site is available after the reaction, as demonstrated in experiments a neoglycoprotein. Adhesion studies reveal a 100-fold increase in endothelial cell attachment for the UEA I/polyethylene terephthalate surface (99.7 ± 29.6 cells/high-power field) when compared with untreated (0.7 ± 0.5), crosslinking agent (0.4 ± 0.3), and denatured UEA I (1.2 ± 1.1) control groups. Five vascular endothelial cell lines adhered to the UEA I/polyethylene terephthalate surface, whereas monocytes, smooth muscle cells, and fibroblasts did not. Conclusion:  These results imply new strategies for endothelialization of prosthetic grafts and promotion of selective cell adherence to biomaterials, with emphasis on carbohydrate interactions. Moreover, this experimental system offers a model for exploring the biologic significance of the endothelial cell-UEA I ligand. (J VASC SURG 1993;18:486-94.)

  • Glycoconjugate mediated endothelial adhesion to Dacron Polyester film cell
    1993
    Co-Authors: C. Keith Ozaki, Matthew D. Phaneuf, William C. Quist, Suchen L Hong, Frank W. Logerfo
    Abstract:

    Purpose: The purpose of this study was to explore new strategies for enhancing specific cell type attachment to biomaterials using immobilized lectins for cell surface glycoconjugates. The lectin Ulex europaeus I (UEA I) has a high affinity for human vascular endothelial cell surface glycoconjugates. Methods: UEA I was covalently bound to polyethylene terephthalate (Dacron) with the cross-linking agent 1-ethyl-3-(dimethylaminopropyl)carbodiimide hydrochloride to achieve oligosaccharide-mediated endothelial cell attachment to this otherwise nonadherent surface. Results: Experiments with radiolabeled UEA I demonstrated covalent linkage of as much as 1.35 ~g/cm 2. The lectin binding site is available after the reaction, as demonstrated in experiments a neoglycoprotein. Adhesion studies reveal a 100-fold increase in endothelial cell attachment for the UEA I/polyethylene terephthalate surface (99.7 + 29.6 cells/high-power field) when compared with untreated (0.7 + 0.5), crosslinking agent (0.4 - 0.3), and denatured UEA I (1.2 + 1.1) control groups. Five vascular endothelial cell lines adhered to the UEA I/polyethylene terephthalate surface, whereas monocytes, smooth muscle cells, and fibroblasts did not. Conclusion: These results imply new strategies for endothelialization of prosthetic grafts and promotion of selective cell adherence to biomaterials, with emphasis on carbohydrate interactions. Moreover, this experimental system offers a model for exploring the biologic significance of the endothelial celI-UEA I ligand. (J VAse SURG 1993;18:48604.)

Craig D Miller - One of the best experts on this subject based on the ideXlab platform.

  • endovascular stent graft repair of thoracic aortic aneurysms
    The Journal of Thoracic and Cardiovascular Surgery, 1996
    Co-Authors: Scott R Mitchell, Michael D Dake, Charles P Semba, Thomas J Fogarty, Christopher K Zarins, Robert P Liddell, Craig D Miller
    Abstract:

    Abstract Conventional repair of aneurysms of the descending thoracic aorta entails thoracotomy and graft interposition. For elderly patients and those with previous operations, obesity, respiratory insufficiency, or other comorbidities, such a procedure entails significant mortality and morbidity. Transluminal stent-graft placement offers an alternative approach with potentially less morbidity and quicker recovery; however, the effectiveness and durability of stent-grafts remain uncertain. Methods: Since July 1992, thoracic aortic stent-grafts have been placed in 44 patients with a variety of pathologic conditions. Each graft was individually constructed from self-expanding, stainless-steel Z stents covered with a woven Dacron Polyester fabric graft. Graft dimensions were determined from spiral computed tomographic scans. All implants were performed in the operating theater under fluoroscopic and transesophageal echocardiographic guidance. Follow-up was by computed tomography and contrast angiography in all cases. Patient data: There were 36 men and 8 women. Mean age was 66 years (range 35 to 88 years). Mean aneurysmal diameter was 6.3 cm (range 4.0 to 9.4 cm). Etiologies included 23 degenerative aneurysms, four posttraumatic aneurysms, four pseudoaneurysms, and one chronic aortic dissection. Results: There were three early deaths ( Conclusions: These early results support the hypothesis that endovascular stent-graft placement may be a safe and durable treatment for selected patients with aneurysmal disease of the descending thoracic aorta. Large introducer size (26F outer diameter) and relatively limited angulation capability, as well as imprecise deployment techniques, currently limit its applicability. Distal embolization and stent migration have not been observed. Failure to achieve complete aneurysmal thrombosis may allow continued aneurysmal expansion and rupture. Further follow-up is clearly necessary to evaluate the true long-term effectiveness of this procedure. (J THORAC CARDIOVASC SURG 1996;111:1054-62)

C. Devine - One of the best experts on this subject based on the ideXlab platform.

  • heparin bonded Dacron or polytetrafluoroethylene for femoropopliteal bypass grafting a multicenter trial
    Journal of Vascular Surgery, 2001
    Co-Authors: C. Devine, B A Hons, Charles Mccollum
    Abstract:

    Abstract Background: Dacron (Polyester fiber) was largely abandoned for femoropopliteal bypass grafts 30 years ago because saphenous vein achieved better patencies. However, in patients taking aspirin, patency in above-knee femoropopliteal bypass grafts has recently been shown to be equivalent to that with saphenous vein. We compared heparin-bonded Dacron (HBD) and polytetrafluoroethylene (PTFE) in a randomized multicenter trial including below-knee popliteal or tibioperoneal trunk bypass graft where the long saphenous vein was absent or inadequate. Methods: Over 28 months, 209 patients undergoing femoropopliteal bypass grafts (180 above-knee, 29 below-knee) were randomized to HBD (n = 106) or PTFE (n = 103). Each patient was given aspirin (300 mg/d) before surgery, and this continued unless the patient had intolerance to the aspirin. Results: The mean follow-up was 42 months (range, 28-55). Fifteen (7.1%) patients died with patent grafts, and three (1.4%) infected grafts were removed. Patency (measured with Kaplan-Meier survival analysis) at 1, 2, and 3 years for HBD was 70%, 63%, and 55% compared with 56%, 46%, and 42%, respectively, for PTFE ( P =.044). A total of 67 secondary interventions were performed on 48 thrombosed grafts; long-term patency was achieved in only three. Risk factors for arterial disease did not significantly influence patency. Amputations have been performed in 23 patients, six after HBD and 17 after PTFE bypass grafts ( P =.015). Conclusions: HBD achieved better patency than PTFE, which carried a high risk of subsequent amputation. (J Vasc Surg 2001;33:533-9.)