Dacron grafts dilate more than Stretch PTFE grafts after abdominal aortic aneurysm repair – long-term results of a prospective randomized trial

BACKGROUND: In this long-term follow-up of a prospective randomized multicentric trial, warp-knitted gelatin-coated double-velour Dacron (GEL-D), warp-knitted collage-coated double-velour Dacron (COL-D) and stretch PTFE bifurcation grafts implanted in patients with abdominal aortic aneurysms (AAA) were compared for their long-term results and their dilatation was evaluated by CT. METHOD: Between 1991 and 1998, 164 AAA patients were prospectively randomized and stratified for age, gender, diabetes, run-off and nicotine consumption. Of these, 55 received GEL-D grafts, 51 COL-D grafts and 58 stretch PTFE grafts. Thirty of them underwent follow-up CT (Computerized Tomography) and graft dilatation was evaluated. RESULTS: The median follow-up time was 77 months. No significant differences were found between the 3 graft materials in median survival and patency rates. The primary 8-year patency rate was 98% for PTFE, 94% for COL-D and 92% for GEL-D (p = 0.4). In 30 patients who had CT scan at a median follow-up at 61 months, graft dilatation was significantly less common with PTFE grafts. Mean inner diameters of the graft body were 110 ± 25% of the original package size for PTFE vs. 132 ± 12% for GEL-D and 131 ± 9% for COL-D. CONCLUSIONS: The 3 graft materials were comparable in long-term patency and complication rates. Graft dilatation was less common with PTFE grafts.