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(Circulation. 2008;117:1873-1882.)
© 2008 American Heart Association, Inc.

New Drugs and Technologies

Modified Prosthetic Vascular Conduits

Muneera R. Kapadia, MD; Daniel A. Popowich, MD; Melina R. Kibbe, MD

From the Division of Vascular Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.

Correspondence to Melina R. Kibbe, MD, Northwestern University, Division of Vascular Surgery, Galter 10–105, 201 E Huron Street, Chicago, IL 60611. E-mail mkibbe{at}nmh.org

Atherosclerosis in the form of peripheral arterial disease results in significant morbidity. Surgical treatment options for peripheral arterial disease include angioplasty, endarterectomy, and bypass grafting. For bypass grafting, vein remains the conduit of choice; however, poor quality and limited availability have led to the use of prosthetic materials. Unfortunately, because of a lack of endothelium and compliance mismatch, neointimal hyperplasia develops aggressively, resulting in high failure rates. To improve graft patency, investigators have developed surgical, chemical, and biological graft modifications. This review describes common prosthetic materials, as well as approaches currently in use and under investigation to modify and improve prosthetic conduits for bypass grafting in an effort to improve graft patency rates.

Key Words: atherosclerosis • bypass • peripheral vascular disease • restenosis • revascularization

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