The lack of suitable autologous grafts and the impossibility of using synthetic prostheses for
small artery reconstruction make it necessary to develop alternative efficient vascular grafts. In this
study, we fabricated an electrospun biodegradable poly(ε-caprolactone) (PCL) prosthesis and poly(3-
hydroxybutyrate-co-3-hydroxyvalerate)/poly(ε-caprolactone) (PHBV/PCL) prosthesis loaded with
iloprost (a prostacyclin analog) as an antithrombotic drug and cationic amphiphile with antibacterial
activity. The prostheses were characterized in terms of their drug release, mechanical properties,
and hemocompatibility. We then compared the long-term patency and remodeling features of PCL
and PHBV/PCL prostheses in a sheep carotid artery interposition model. The research findings
verified that the drug coating of both types of prostheses improved their hemocompatibility and
tensile strength. The 6-month primary patency of the PCL/Ilo/A prostheses was 50%, while all
PHBV/PCL/Ilo/A implants were occluded at the same time point. The PCL/Ilo/A prostheses were
completely endothelialized, in contrast to the PHBV/PCL/Ilo/A conduits, which had no endothelial
cells on the inner layer. The polymeric material of both prostheses degraded and was replaced with
neotissue containing smooth-muscle cells; macrophages; proteins of the extracellular matrix such
as type I, III, and IV collagens; and vasa vasorum. Thus, the biodegradable PCL/Ilo/A prostheses
demonstrate better regenerative potential than PHBV/PCL-based implants and are more suitable for
clinical use.