Clinical Use of Synthetic Arterial Substitutes in Three Hundred Seventeen Patients

In recent years increasing interest has been devoted to the direct surgical treatment of various forms of aortic and arterial disease. In general, three principles of therapy have been developed, namely, excision with restoration of normal continuity, the by-pass procedure, and thromboendarterectomy. The indications for each of these procedures is dependent upon the nature and extent of the disease. Although the value and efficacy of these methods of therapy have now become well established, there remain certain problems in their practical application. These are concerned particularly with the first two methods, in which a vascular replacement is required. The significance of this problem is well illustrated by our own experience. Thus, during the six-year period since the adoption of these methods of therapy we have employed some form of vascular replacement in approximately 1000 cases. In the great majority of these, more than three-fourths of the cases, homografts have been