Vascular Grafts Market

An aneurysm that once meant open surgery is now often treated through a groin puncture, and the graft that makes that possible costs several times the fabric tube it replaced. Douglas Insights values the vascular grafts market at USD 3.14 billion in 2025 and expects USD 5.43 billion by 2035, compounding at 5.63%. The estimate is built from the bottom up: roughly 1.46 million vascular grafts implanted in 2025 across endovascular stent grafts, peripheral and bypass surgical grafts, haemodialysis access grafts, and biological and bioengineered grafts, at an average realised price of USD 2,150 per graft, triangulated against procedure volumes for aneurysm repair, peripheral bypass and dialysis access, and manufacturer disclosures. Grafts implanted grow 5.0% a year with ageing populations and rising vascular disease, while price per graft rises 0.6% a year as newer stent graft designs and bioengineered vessels offset price pressure. Coronary and peripheral stents without graft fabric, heart valves, and the patient’s own veins and arteries used as grafts are excluded. This study sits within our cardiovascular devices coverage and follows the published Douglas Insights methodology.

How did stent grafts change aneurysm surgery?

By replacing major open abdominal surgery with a procedure through small incisions in the groin, which transformed how aortic aneurysms are treated. An aortic aneurysm is a dangerous bulge in the body’s main artery that can rupture and cause death within minutes. Traditional repair meant opening the abdomen or chest, clamping the aorta and sewing in a fabric tube graft, a major operation with a long recovery. Endovascular aneurysm repair instead threads a stent graft, a fabric tube supported by a metal frame, through the arteries from the groin and expands it inside the aneurysm, sealing it off from blood pressure. Recovery is much faster and early risks lower, so endovascular repair has become the preferred approach for many patients, and stent grafts now account for the largest share of vascular graft value. The trade off is that endovascular repairs need lifelong imaging follow up and sometimes further procedures, because grafts can leak or shift. Complex designs now treat aneurysms near branch arteries. The exclusive chapter of this report tracks procedure volumes by approach and region, since the shift from open to endovascular repair shapes the market.

What does this market include?

This study covers manufactured and bioengineered grafts used to replace, bypass or line blood vessels. Endovascular stent grafts cover stent grafts for abdominal and thoracic aortic aneurysms and other endovascular repairs, the largest category. Peripheral and bypass surgical grafts cover synthetic grafts made of expanded polytetrafluoroethylene or polyester used in surgical bypass of blocked leg arteries and in open aortic repair. Haemodialysis access grafts cover grafts that create access points for dialysis in patients with kidney failure. Biological and bioengineered grafts cover grafts made from processed animal or human tissue and tissue engineered vessels. Coronary and peripheral stents without graft fabric, heart valves, the patient’s own veins and arteries harvested for bypass, and surgical procedure costs sit outside the boundary. Value is measured at manufacturer realised price.

Why are small synthetic grafts so hard to make?

Because synthetic grafts work well in large arteries where blood flows fast, but in small vessels they tend to clot and block, which is why heart bypass surgery still relies on the patient’s own vessels. Synthetic fabric grafts perform reliably in the aorta and large leg arteries, where high flow keeps them open. In small diameter vessels, such as coronary arteries or arteries below the knee, synthetic grafts are prone to blockage because blood clots and scar tissue build up on their surfaces. Surgeons therefore harvest veins or arteries from the patient’s own body for coronary bypass and many lower leg bypasses, adding surgery and not always possible if the patient’s vessels are unsuitable. This has driven long running research into bioengineered vessels, grown from human cells and processed to remove cells so that they are not rejected, and a bioengineered human vessel received approval in the United States for vascular trauma. These may eventually offer better options for small vessels, dialysis access and patients who lack suitable veins. The model treats bioengineered grafts as a small but growing category.

What drives demand?

The first driver is ageing populations. Aortic aneurysms and peripheral artery disease become more common with age, increasing procedures.

The second driver is kidney failure. Rising numbers of patients on dialysis, driven by diabetes and hypertension and sized in the Dialysis Equipment Market report, need vascular access, some through grafts.

The third driver is endovascular technology. Stent grafts that treat more complex aneurysms extend minimally invasive repair to more patients.

The fourth driver is screening and access. Aneurysm screening programmes and expanding healthcare in emerging markets identify and treat more patients.

What restrains the market?

Three restraints are modelled. Graft complications are the first: infection, blockage and endoleaks can require further procedures, and concerns about long term durability affect choices. Pricing pressure is second: hospital purchasing and reimbursement constraints limit prices. Alternatives are third: in dialysis, the preferred access is an arteriovenous fistula made from the patient’s own vessels, limiting graft use, and drug and stent therapies compete with bypass surgery for peripheral disease.

Which categories carry the value?

Endovascular stent grafts lead with 52% of 2025 value, USD 1,632.3 million. Peripheral and bypass surgical grafts hold 20%, USD 627.8 million. Haemodialysis access grafts account for 16%, USD 502.2 million, and biological and bioengineered grafts 12%, USD 376.7 million, the latter growing fastest. Each category is modelled through 2035 by region.

Where are vascular grafts used?

North America leads with 42% of 2025 value, USD 1,318.4 million, growing 4.97% a year, reflecting high procedure volumes and early adoption of complex stent grafts. Europe holds 28%, USD 878.9 million, at 4.8%, with established aneurysm screening in some countries. Asia Pacific holds 22%, USD 690.6 million, and grows fastest at 7.4%, driven by ageing and expanding access in China, Japan and India. Latin America contributes USD 125.6 million at 6.4%, the Middle East USD 94.2 million at 6.8% and Africa USD 31.4 million at 6.0%. Six regional models sum to the global figure, with country tables in the Excel model.

Who makes vascular grafts?

W. L. Gore and Associates, Medtronic and Cook Medical are leading suppliers of stent grafts and synthetic grafts. Terumo, through Terumo Aortic, Getinge, BD, Artivion, LeMaitre Vascular and Endologix supply surgical and endovascular grafts, and Humacyte develops bioengineered vessels. Chinese manufacturers such as MicroPort supply domestic stent grafts. The competitive chapter profiles each manufacturer’s products and regional presence.

How are vascular grafts priced?

Average realised price is USD 2,150 per graft in 2025, spanning a wide range. Standard synthetic surgical and dialysis grafts cost a few hundred to a few thousand dollars, while endovascular stent graft systems cost many thousands, and custom or complex branched and fenestrated stent grafts cost considerably more. Bioengineered vessels carry premium prices. Newer designs and bioengineered grafts raise average prices slightly despite purchasing pressure. The pricing chapter publishes price bands by category.

How do the scenarios diverge by 2035?

The base case carries 5.0% growth in grafts and 0.6% price growth for a 5.63% revenue CAGR and USD 5,428.3 million in 2035. The price-pressure scenario, in which purchasing constraints tighten and alternatives reduce graft use, sets the legs at 3.2% and minus 0.6%, landing near USD 4,050 million. The innovation scenario, in which complex endovascular repair and bioengineered vessels expand, sets them at 6.4% and 1.4%, carrying the market past USD 6,700 million. Each 1-point change in graft growth moves the 2035 figure by roughly USD 520 million.

Which rules and standards apply?

Three layers matter. Medical device regulation comes first: vascular grafts and stent grafts are high risk implantable devices requiring approval, and bioengineered vessels face biologics regulation. Clinical guidelines are second: vascular society guidelines on aneurysm repair and dialysis access shape treatment choices. Reimbursement is third: payment for procedures and devices influences adoption. The regulatory chapter maps these requirements by jurisdiction.

Is endovascular repair always better?

Not in every case, which is why open surgical repair with fabric grafts remains important. Endovascular repair offers lower early risk and faster recovery, but long term studies have shown that the early advantage narrows over time, and endovascular patients need lifelong monitoring and more often require further procedures. Younger, fitter patients and those with anatomy unsuitable for stent grafts may be better served by open repair. Guidelines therefore recommend individualised decisions. The model assumes endovascular repair continues to grow its share while open repair remains an important option.

Douglas Exclusive: the vascular procedure volume tracker

This report tracks, by region and procedure, aortic aneurysm repairs by approach, peripheral bypass, dialysis access and graft usage, converting disease epidemiology into graft volumes and value by category and region. Licence holders receive it as a maintained tab in the Excel model.

Methodology and receipts

The model is built bottom-up from grafts: procedure volumes for aneurysm repair, peripheral bypass and dialysis access by region, graft usage per procedure, category mix, and realised prices from manufacturer disclosures, with stents without graft fabric, heart valves, autologous vessels and procedure costs excluded. Every figure carries a numbered source and a confidence grade in the fact sheet above, and the working model ships with every licence. The next scheduled review of this study is September 2027.