Open AccessThe Preclotting of Porous Arterial Prostheses
Author(s) -
Stanley G. Yates,
Aires A.B. Barros D’Sa,
K Berger,
Luis Fernandez,
Stephen Wood,
Edward A. Rittenhouse,
Christophér C. Davis,
Peter Mansfield,
Lester R. Sauvage
Publication year - 1978
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197811000-00005
Subject(s) - medicine , heparin , fibrin , impervious surface , prosthesis , surgery , femoral artery , biomedical engineering , clamp , aortic bifurcation , aorta , mechanical engineering , ecology , clamping , engineering , immunology , biology
A four-step preclotting method is presented for use with porous filamentous Dacron prostheses in the fully-heparinized patient. The method employs controlled fibrin formation within graft interstices, heparin neutralization of all thrombin remaining in the graft wall, and delay of systemic heparin neutralization until 15--20 minutes after clamp release. The resulting flow surface is impervious, smooth and hypothrombogenic. Experimental data are presented which support the rationale of this four-step preclotting method. Four years of clinical experience with the method are summarized, involving 300 prosthesis limbs used in aortic bifurcation, aortofemoral, femorofemoral, axillary-femoral and femoropopliteal positions in 192 patients. A clinical perspective of preclotting techniques is presented in which the proper use of this new method is suggested.