Compliance of Textile Vascular Prostheses Is a Fleeting Reality

In vivo evaluation of a novel compliance-matching vascular graft

“…The same could apply to the positive effects of matching compliance, as long as the graft could retain its compliance over time. Although the compliance of explanted grafts requires further investigation, it was suggested that woven and knitted polymer grafts gradually lose their compliance due to tissue ingrowth 41,42 or due to irreversible yarn rearrangement caused by cyclic loading 43 . We expect that these two mechanisms will only moderately impact our CM graft, because the compliance of the CM graft is regulated by the stent layer in a manner nearly independent of the properties of the inner graft.…”

“…Since then, there has been a notable lack of grafts that could resolve this issue, especially in the case of large-diameter grafts, such as those used for aortic replacement. Regardless of size, compliance mismatch in combination with other suboptimal characteristics, such as the deterioration of mechanical properties and dilatation with time, results in the inadequate performance and poor surgical outcomes of existing grafts 7 . Consequently, current grafts fail to adequately reduce the burden of cardiovascular diseases that still constitute the leading cause of death and disability worldwide, with a continuously rising tendency 8 .…”

Remodeling of structurally reinforced (TPU+PCL/PCL)-Hep electrospun small-diameter bilayer vascular grafts interposed in rat abdominal aortas

“…The compliance can be referred to as a dynamic response between intraluminal pressure and arterial wall deformation, and it serves as an important property that influences the short-and long-term performances of artificial blood vessels. 31 In this study, the TPU with the good biocompatibility and mechanical properties similar to native vascular tissues was co-electrospun with PCL onto the outer surface of PCL-Hep SLVGs, improving the compliance. For example, the compliance was increased from 3.72 ± 0.06% for the PCL-Hep SLVGs to 4.51 ± 0.11% for (TPU+PCL/PCL)-Hep BLVGs (Table S1 †).…”

“…However, there are a number of cues citing the compliance mismatch as an alternative cause of vascular graft failure. [29][30][31] This is because a decrease in compliance leads to the hemodynamic environmental changes or the non-homeostatic mechanical strains that promote the development of intimal hyperplasia, thrombus formation, and graft failure ultimately. [32][33][34] Consequently, these critical structural design and fabrication criteria should be met in the research and development of either clinical or preclinical small-diameter artificial blood vessels.…”

Degradation phenomena on last generations of polyethylene terephthalate knitted vascular prostheses

“…New generations of PET VGs have been proposed to better mimic arterial mechanical properties to enhance their compliance by introducing the concept of thin-wall VGs. We previously demonstrated that they did not fulfill expectations in terms of compliance, 9 but the long-term durability of these thinner structures remains unclear. Previous reports concluded that new generations of PET VGs are still subjected to long-term degradation mechanisms.…”