Small-diameter compliant arterial graft prosthesis: Design concept of coaxial double tubular graft and its fabrication

To minimize compliance mismatch between native artery and arterial graft prosthesis over the entire pressure regions, we proposed a coaxial double tubular artificial graft which consists of an enhanced compliant inner tube and a less compliant outer tube, both of which were fabricated using well-controlled multiply micropored segmented polyurethane (SPU) films. Double tubular grafts were coaxially assembled by inserting the inner tube into the outer tube. First, the pressure-diameter (P-D) relationship of canine common carotid arteries, which exhibited a "J" curve, was determined as a targeted artery. Two determinant variables, the pressure-induced distensibility of each tube and the intertubular space distance, were defined and formulated in several models of coaxial double tubular SPU grafts, which had various intertubular space distances, micropore densities, and wall thicknesses. The distensibility of the inner tube determined the distensibility in the low-pressure regions, which was adjusted using wall thickness and microporosity. Thinner films with higher porosities resulted in a high pressure-induced distensibility. On the other hand, a low pressure-induced distensibility in the high-pressure regions was realized using an outer tube with a thicker wall and lower microporosity. The transition point from low- to high-pressure regions was determined by the intertubular distance using the theoretical values. On the basis of these results, we presented a prototype model of a coaxial double tubular graft that exhibited well-matched compliance with canine carotid artery.