USE OF BIOPROSTHESIS WITH EXTERNAL SUPPORT BY KNITTED NITINOL MESH AS A CONDUIT IN INFRAINGUINAL BYPASS SURGERY: RANDOMIZED CONTROLLED TRIAL

Abstract

Background. Autovein is considered as the best prosthesis in the infrainguinal bypass surgery. However, in 30 % of individuals great saphenous vein is inappropriate for grafting because it is too small or due to phlebitis, varicosity and prior surgery. From this point of view, decellularized vascular grafts, which retain most of the properties of living tissues, seem quite interesting. Due to the high frequency of development of prosthetic aneurysm in the postoperative period xenografts does not gain high popularity. This complication occurs in an average of 6 % of cases, but modern technological advances in manufacture of xenografts have reduced the percentage of aneurysms to 4.1 %, which is still high. To solve this problem, we decided to use external support of nitinol mesh. Aim: assessment of efficiency of bioprosthesis with external support by knitted nitinol mesh as a conduit in infrainguinal bypass surgery. Materials and methods. It was a single-center randomized controlled trial in two groups, 36 patients in each group. There were no statistically significant differences between the groups. Patients of the control group underwent a standard femoropopliteal bypass surgery. In experimental group we used bioprosthesis with external support by knitted nitinol mesh. Results. Aneurysms development was observed in 6 patients (16.67 %) of the control group (4 patients - anastomotic aneurysms; 2 patients - true shunt aneurysms). There were no aneurysms in the experimental group (p < 0.05). Conclusion. The use of a nitinol-based mesh effectively prevents the development of an aneurysm of the xenograft in the postoperative period.

Keywords

• xenoprothesis
• titanium nickelide
• extravasal construction
• reinforced xenoprothesis
• xenoprothesis with external support
• nitinol
• aneurysm