Mechanical causes of early and late graft thrombosis

Mechanical factors can lead to both early and late infrainguinal graft failures. Errors made in suture line construction are the most frequent cause of early graft failure. Graft placement and vein graft preparation are important in preventing other early mechanical problems. Late graft failures are related to the way that the graft heals both externally and internally. Kinking of the graft, fibrotic valves and lumen narrowing secondary to endothelial cell and intimal injury in saphenous vein grafts are the most common causes of late mechanical graft failures.