Use of spiral laminar flow technology in peripheral bypass grafts

Presented at the 34th Charing Cross International Symposium. April 2012 Mr N Shaper, Bradford General Hospital

Summary of presentation

Spiral Laminar Flow (SLF) exhibits biological advantages:

  • Holds cellular components in the centre of the flow
  • Reduces near wall kinetic energy turbulence
  • Reduces pressure drops across arterial branch points
  • Should result in reduced downstream disease progression

A registry series experience using the Spiral Flow PV Graft between Feb 2011 and April 2012

Demographics

  • 17 implanted
  • 73% male / 27% female
  • Mean age at operation 67.7 (47.6 to 91.3) years
  • 47% diabetic
  • 30% right leg / 70% left leg
  • 47% severe claudication / 53% critical ischemia

Operative details

  • 65% above knee popliteal
  • 18% below knee popliteal with vein cuff
  • 17% tibial vessels with vein cuff

Challenging cases

1 x ‘Y’ graft onto distal limb of posterior tibial artery

1 x common femoral artery to contralateral distal anterior tibial artery

2 x common iliac transobturator to the above knee popliteal artery

Doppler ultrasound review

SLF observed at distal anastomosis and all run-off vessels in all cases in all post-op and subsequent scans.

Results at April 2012

  • Primary patency rate: 93% at mean follow-up 4.47 (0 to 12.2) months
  • Secondary patency rate: 100%, single graft, occluded 5.5 months post-op was successfully thrombolysed; re-occluded three months later, thrombolysed and angioplasty to the tibia-peroneal trunk, patient warfarenised and still patent.

Early results are encouraging with SLF PV grafts showing good primary patency rates.

Future work

More data required on the performance of the Spiral Flow PV Graft bench marked against conventional grafts.