single-dose external pre-insertion gamma radiation of vein grafts reduced the amount of intimal hyperplasia in this animal model.

Objectives: The performance of small-diameter (3–5-mm) vascular grafts still poses a challenge in the field of vascular surgery. We present here our preliminary experience with implanting unique small-sized polycarbonate urethane vascular grafts in 7 dogs. Material and Methods: Each animal was implanted with 4 interposition grafts, 2 femoral and 2 carotid. No anti-thrombotic medication was administered. Doppler sonography was performed at 3-month intervals to examine for patency and flow characteristics. Animals were sacrificed electively at 3, 6 and 12 months. Results: At 3 months, all grafts were patent. After 6 months, 3 grafts occluded and at 1 year a further 6 grafts occluded. Hence 9 of 28 grafts occluded (67.9% patency). During the study, no correlation could be established between flow velocity or resistance index and occlusion. Histopathology showed intimal hyperplasia to be the cause of occlusion. Conclusions: Compared to literature data on small-diameter grafts in the same position, ADIAM’s Biomechanical grafts performed clearly better. Compliance data suggest a correlation between elastic compliance and patency.

Data on clinical biology amounted to € 17.13 per patient; on average 15 types of lab tests were used. Costs for imaging also varied by severity and were € 876.58, € 866.29, € 930.07 and € 1,247.45 for increasing levels of SOI. In total 39 different imaging tests were used covering among others functional measurements, radiology, Rx, CT and MRI. Total costs amounted to € 3,653 , € 5,583 , € 9,489 , € 16,660 respectively. Compared to the national average these costs are 5% lower, mainly due to underestimation of honoraria. ConClusions: In-hospital costs increase with stroke severity, with the most severe patients costing 4.5 times more than mild patients. Bottom-up costing approximated the top-down costs.