| Abstract: | Silk vascular prostheses have been used
clinically since August 1957 with no clinical
ruptures. The longest follow up is 18 years in
extremity artery aneurysmectomy, 13 years and
8 months in thoraco-abdominal aortic bypass and
14 years in abdominal aorta aneurysmectomy
with patency rates of 70-80%, 92% and 96.2% in
498 cases operated upon.
Silk prostheses are physicochemically inert,
do not cause host foreign body expulsion reac-
tion. nonallergenic, noncarcinogenic, durable,
sterilizable, inexpensive, easily manufactured,
porous, seamleTs.s, elastic (do not collapse or kink
on bending), thermostable, not modified by weak
acids or alkalis and have no noticeable tensile
strength change after contact with pH 7.4 human
blood.
For successful grafting meticulous surgical
technic, strict asepsis, proper graft caliber and
strength, good run-off, good host vessel condi-
tion and 3-4 week postoperative bed rest are
mandatory.
Silk prostheses suffer partial loss of elasticity
and corrugation on autoclaving, at less than 5 mm
diameter prostheses patency is only 40% and vein
graft value is questionable, these reciuire im-
proving. |
