In Vivo Study of Expanded Polytetrafluoroethylene Vascular Suture

Routine use of high-quality suture material has often been described as a factor in preventing complications such as false aneurysms, infection, and me chanical failure of implanted gafts. Optimal characteristics for a vascular su ture are to maintain its strength without causing an important "foreign body" reaction. Polypropylene monofilament has both characteristics and successfully replaced braided sutures for many years. A new monofilament suture material, which is made of expanded polytetrafluoroethylene (EPTFE), has recently been introduced. The purpose of the present study was to evaluate this new vascular suture and compare it with the widely and successfully used polypropylene su ture. The authors implanted a total of 20 infrarenal aortic reconstructions in dogs using both sutures to perform each anastomosis. Two dogs were sacrificed after 3, 7, 10, 14, 21, 30, 60, 120, 285, and 360 days. Light and scanning electron microscopy of the anastomotic site was routinely performed in order to compare the two suture materials. Thickness of inflam matory reaction around the sutures was measured at three different sites of each suture and statistically compared. Inflammatory reaction was minimal for both sutures and no significant difference was noticed by use of the Student's T- test (p=NS). No ingrowth was shown in either suture. EPTFE, in contrast to polypropylene, at scan electron microscopy, showed a nice layer of fibrin sur rounding the suture and a tendency to adapt to mechanical stress by being oval, elliptical, or circular. In the authors' opinion, EPTFE suture is, therefore, a valuable alternative for use in cardiovascular surgery.