Dilation of woven and knitted aortic prosthetic grafts: CT scan evaluation

Abstract

Because there are few reports in the literature concerning short- and medium-term outcome of woven and knitted aortic prosthetic grafts, we conducted CT evaluations in 58 asymptomatic patients (53 males and five females with a mean age of 63.5 years) undergoing infrarenal aortic reconstruction between June 1988 and June 1991. Joined CT slices after contrast enhancement, centered on the proximal anastomoses, prosthetic bodies, and prosthetic limbs, were obtained in the early (mean 19 days) and late (mean 19 months, range 6 to 40 months) postoperative periods. In end-to-side aortoprosthetic anastomoses (n=28), early and late CT examinations revealed that the anteroposterior diameter increased 1.9% (p=NS) and 8.8% (p<0.0001) for woven and knitted grafts, respectively. In end-to-end aortoprosthetic anastomoses, the diameter of the prosthetic body on early CT scans increased 12.6% (p<0.0001) and 28% (p<0.0001) for woven and knitted prosthetic grafts, respectively, as compared with diameter values provided by the manufacturer. Dilation continued to progress 2.2% (p<0.04) for woven and 6.2% (p<0.0002) for knitted prosthetic grafts on late CT scans. The mean diameter of the prosthetic graft limbs (n=96) increased 22.3% (p<0.0001) and 34.6% (p<0.0001) for woven and knitted prosthetic grafts, respectively, on early CT scans as compared with manufacturers' values. Secondary increases were 3.2% (p<0.002) and 7.7% (p<0.007) for woven and knitted prosthetic grafts, respectively. These data show that dilation of aortic prostheses occurs early in most cases, most likely soon after declamping of the graft, as shown by recent intraoperative measurements. Secondary progression is slow but more marked for knitted prostheses.